CROI 2015 Program and Abstracts

Abstract Listing

Poster Abstracts

attention, memory, executive- and visual-motor functioning. Subsequently, all participants underwent an advanced 3TESLA MRI-scan for the evaluation of intracerebral volumes and white matter integrity. White matter integrity was measured by MRI sequences for white matter diffusivity and white matter hyperintensities. Results: In total, 35 perinatally HIV-infected (median age: 13.8 years, median CD4 + T-cells: 770*10 6 /L, 89% on cART, 83%with an undetectable HIV VL) and 37 healthy children (median age: 12.1 years) were included. HIV-infected children performed poorer on all cognitive domains (Table 1), and had a lower grey matter volume (HIV: 666.3 cm 3 , SD 56.7; healthy: 699.9 cm 3 , SD 74.5, p =0.023), a higher white matter diffusivity (HIV: 8.0x10 -4 , SD 0.3; healthy: 7.7x10 -4 , SD 0.2, p <0.001) and more white matter hyperintensities (HIV: 59%; healthy: 18%, p <0.001).

Conclusions: Children with HIV had a lower grey matter volume and a decreased white matter integrity as compared to healthy, matched controls. These observations occur in the context of poorer overall cognitive functioning in the HIV-infected group, which warrants further studies investigating the explanatory value of brain volumes and white matter integrity for cognitive performance in HIV-infected children. More insight in the observed cognitive deficits and intracerebral alterations is essential as these factors may influence future intellectual performance, job opportunities and community participation of HIV-infected children. 936 Executive Functions Among Perinatally HIV-Exposed and HIV-Infected Youth Sharon L. Nichols 1 ; Miriam Chernoff 2 ; Kathleen M. Malee 3 ; Patricia A. Sirois 4 ; Paige L.Williams 2 ; Betsy L. Kammerer 5 the Memory SubstudyTeam of the Pediatric HIV/AIDS Cohort Study (PHACS) 1 University of California, San Diego, La Jolla, CA, US; 2 Harvard School of Public Health, Center for Biostatistics in AIDS Research, Boston, MA, US; 3 Northwestern University Feinberg School of Medicine, Chicago, IL, US; 4 Tulane University School of Medicine, New Orleans, LA, US; 5 Children’s Hospital Boston, Boston, MA, US Background: Executive functions (EF), including organization, inhibition, and planning, are critical for management of daily activities. Evidence suggests HIV may impact EF in adults. The effect of perinatally acquired HIV (PHIV) on EF in children and youth is less well understood despite the potential importance of EF in everyday life, including academics, risk behavior management, medication adherence, and health care. This study compared EF in youth with PHIV and perinatally HIV-exposed but uninfected youth (PHEU). Methods: Four Delis-Kaplan Executive Function System (D-KEFS) subtests were administered to 173 PHIV and 85 PHEU youth, ages 9-19, enrolled in a substudy of the PHACS Adolescent Master Protocol. Youth with PHIV, with and without a history of CDC Class C conditions (PHIV-C, n=45, and PHIV-non-C, n=128), were compared to each other and to PHEU youth. Associations with measures of current and past disease severity (HIV RNA, CD4%) were evaluated. Analyses used linear regression models implemented via generalized estimating equations, adjusting for demographic and socioeconomic covariates. Results: The majority of participants were Black (77%); 18%were Hispanic, and 54% female. Mean ages at entry were 12.9 years (PHEU), 14.5 years (PHIV-non-C), and 15.5 years (PHIV-C). 75% of PHIV-non-C and 64% of PHIV-C had current HIV RNA <400 copies. After adjustment for potential confounders, the PHIV-C group was significantly (p<0.05) slower and made more errors on Inhibition and were significantly slower on the Color Naming/Reading Combined conditions of the Color-Word Interference subtest (see Table). This group also had significantly lower unadjusted, but not adjusted, scores on some verbal and visual fluency conditions; there were no differences for verbal problem-solving. PHIV-non-C and PHEU did not differ on any measure. Prior encephalopathy was associated with slower Verbal Fluency, Color Naming and Inhibition trial performance. Associations of test results with HIV RNA, CD4%, and age at greatest disease severity were complex.

Poster Abstracts

Conclusions: Youth with PHIV and a history of greater disease severity showed poorer performance on select measures of EF; however, observed lower EF skills in this population may be related in part to underlying factors such as cognitive speed and efficiency. Relationships of EF development with degree and timing of disease progression in childhood require further study. Implications for long-term outcomes and interventions are important avenues for follow-up.

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CROI 2015