CROI 2015 Program and Abstracts

Abstract Listing

Poster Abstracts

Conclusions: Delaying ART initiation until older childhood substantially delays pubertal development and menarche, independently of immune-suppression. Factors other than CD4, such as pubertal development, need consideration when making decisions about timing of ART initiation in older children. 917 Mortality of HIV-Infected Youth in the Combination Antiretroviral Therapy (cART) Era Gayatri Mirani 1 ; Paige L.Williams 2 ; Miriam Chernoff 2 ; Mark Abzug 6 ; Myron Levin 3 ; James Oleske 4 ; George Seage 2 ; Rohan Hazra 5 ; Russell B.Van Dyke 1 On behalf of the International Maternal Pediatric Adolsescent AIDS ClinicalTrials (IMPAACT) Network P1074 StudyTeam 1 Tulane University Health Sciences Center, New Orleans, LA, US; 2 Center for Biostatistics in AIDS Research Harvard School of Public Health, Boston, MA, US; 3 University of Colorado Anschutz Medical Campus, Aurora, CO, US; 4 Division of Pediatrics Allergy, Immunology & Infectious Diseases, Newark, NJ, US; 5 Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, US; 6 University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, CO, US; 7 IMPAACT Operations Center FHI 360, Durham, NC, US Background: cART has resulted in a decrease in HIV-related opportunistic infections and deaths. However, deaths from infectious and non-infectious conditions continue to occur. We reviewed deaths in IMPAACT P1074, a recent prospective cohort study of HIV-infected youth, to characterize those dying with HIV. Methods: IMPAACT P1074 is a prospective, multicenter surveillance study of long-term outcomes in HIV-infected infants, children, and adolescents. HIV-infected youth enrolled in previous IMPAACT studies were enrolled between April 2009 and June 2013. Annual chart abstractions were conducted to collect demographics, antiretroviral therapy, heights and weights, CD4 counts, HIV viral loads, clinical diagnoses and deaths. Details of deaths were recorded on a study form and autopsy reports were reviewed when available. We compared demographic and health characteristics of those who died and those who survived through June 2014. Results: Of 1201 subjects, 87%were perinatally infected with a mean age of 20.6 years at last chart review. There were 28 deaths (mortality rate 7.1/1000 person years), with 3 deaths in 2010, 3 in 2011, 14 in 2012, 7 in 2013 and 1 in 2014. The mean age at death was 23.5 years (Table). Those who died were older and less likely to be on cART at the end of study-followup and had persistently lower CD4 counts and higher viral loads. The groups did not differ by sex, race/ethnicity, route of HIV acquisition, or BMI z-scores. Causes of death were derived from autopsy reports (3), study site records (12), family/friends report (6), primary HIV care provider (6) and obituary (1). Causes of death were wasting/ multi-organ system failure/end stage AIDS (5), pneumonia (5), PML (4), PCP (2), disseminated MAI (2), B-cell lymphoma (2), suicide (2), sepsis (1), HIV-related cardiomyopathy (1), homicide (1) motor vehicle accident (1), hepatic failure (1), and tuberculosis meningitis (1).

Poster Abstracts

551

CROI 2015