CROI 2015 Program and Abstracts

Abstract Listing

Poster Abstracts

Conclusions: Our data document the occurrence of chronic conditions among HIV-infected adults in North America, particularly among older adults and those with more profound immunosuppression. These findings support the need for comprehensive management and interventions that address complex health needs beyond antiretroviral therapy among aging HIV-infected persons. 1054 A Retrospective Population-Based Examination of Prescription Drug Usage Prior to HIV Diagnosis Among HIV Cases and Their Controls: The Missed Opportunity for Diagnoses Epidemiological Study (MODES) Souradet Y. Shaw 1 ; Laurie Ireland 2 ;Tara Carnochan 2 ; NancyYu 1 ; Carla Ens 3 ;Yoav Keynan 1 ; Ken Kasper 4 ; Marissa Becker 1 On behalf of the MODES ManitobaTeam 1 University of Manitoba, Winnipeg, Canada; 2 Nine Circles Community Health Centre, Winnipeg, Canada; 3 Manitoba Health, Winnipeg, Canada; 4 Manitoba HIV Program, Winnipeg, Canada Background: In North America, HIV positive individuals continue to present at advanced stages of the disease. Understanding healthcare utilization patterns of HIV positive individuals prior to their diagnosis, such as prescription drug usage, can inform engagement strategies, earlier diagnosis and identification of health care needs. Methods: This was a population-based, case-control analysis of prescription drug usage of HIV-positive individuals presenting to care between 2007-2011 to the Manitoba HIV program (MHP). HIV cases were age-, sex- and region-matched to their HIV-negative controls at a 1:5 ratio. Clinical information fromMHP was linked to the Drug Program Information Network, a real-time database of all drug dispensations in Manitoba. Rates of prescription drug dispensations were calculated for cases and controls. In order to address potential confounding, the total number of pills prescribed, normalized to 7-day dispensation cycles was used as the numerator (as opposed to strictly the number of dispensations). Person-days prior to HIV diagnosis was calculated and used as the denominator in rate calculations. Dispensations were categorized into prescriptions for antibiotics, chronic disease conditions (e.g., asthmas, hypertension) and mental health conditions (e.g., anxiety, bipolar, depression, etc.). Stratified Poisson regression models were used to compare rates between cases and controls. Relative rates (RRs) and their 95% confidence intervals (95%CI) are reported Results: A total of 164 cases and 809 controls were included. In the year prior to HIV diagnosis, and compared to HIV-negative controls, HIV cases had significantly higher dispensation rates for antibiotics (RR: 3.2, 95%CI: 2.8-3.7), and drugs used to treat diabetes (RR: 1.2, 95%CI: 1.1-1.3), and respiratory conditions (RR: 1.7, 95%CI: 1.4-2.1), while having lower rates for drugs used for hyperlipidemia (RR: 0.7, 95%CI: 0.6-0.8) and hypertension (RR: 0.6, 95%CI: 0.6-0.7). For mental health conditions, HIV cases had significantly higher rates for drugs used to treat anxiety (RR: 2.2, 95%CI: 2.0-2.5), bipolar disorder (RR: 1.4, 95%CI: 1.2-1.7) and mood disorders (RR: 1.1, 95%CI: 1.0-1.2). HIV cases had significantly lower rates for drugs used in the treatment of schizophrenia (RR: 0.7, 95%CI: 0.6-0.8). Conclusions: With a few exceptions, HIV cases had higher dispensation rates, suggesting both higher co-morbidities and missed opportunities for prevention and care 1055 Elevated Rates of Injury Among HIV-Positive Individuals in British Columbia Hasina Samji 1 ; Dmitry Shopin 1 ;Wendy Zhang 1 ; Oghenowede Eyawo 1 ; Guillaume Colley 1 ; Mark Hull 1 ; Julio Montaner 3 ; Robert Hogg 2 On behalf of the COAST Study 1 BC Centre for Excellence in HIV/AIDS, Vancouver, Canada; 2 Simon Fraser University, Burnaby, Canada; 3 University of British Columbia, Vancouver, Canada Background: Injuries are responsible for significant morbidity and mortality, constituting the third leading cause of death and the leading cause of death for those between the ages of 1 and 44 years. The epidemiology of injury in HIV+ individuals has not been well-elucidated. This study seeks to characterize the burden of injuries among HIV+ individuals in comparison to the general population in British Columbia (BC), Canada. Methods: A population-based dataset was created via linkage between the BC Centre for Excellence in HIV/AIDS and PopulationData BC . Our analytic sample consisted of HIV+ adults in BC identified using validated case-finding algorithms (cohort 1) and a random 1% sample of the adult general population in BC (cohort 2). The International Classification of Diseases 9 and 10 codes were used to classify unintentional (falls, motor vehicle collisions, poisoning, suffocation, fire/burns, natural/environmental, other land transportation and cut/pierce injuries) and intentional (self-harm and assault) injuries based on the external cause of the injury. Incidence rates and 95% confidence intervals were calculated overall for each injury category as well as for sub-categories listed above over the period from 1996 to 2010. Results: 12,120 (80%male) and 94,373 (50%male) contributed 114,268 and 943,861 person-years (PY) to cohorts 1 and 2, respectively. The incidence of unintentional injury was 18.58/1000PY (95%CI: 17.80-19.39) in cohort 1 and 8.21/1000PY (95%CI: 8.02-8.40) in cohort 2 (p<0.001). Rates of intentional injury were 14.69/1000PY (95%CI: 13.97-15.38) and 1.72/1000PY (95% CI: 1.64-1.81), in cohorts 1 and 2, respectively (p<0.001). Figure 1 demonstrates a decreasing trend in unintentional and intentional injury among HIV+ individuals over time, while the incidence of injury remains relatively constant in the general population. The highest rates of injury in cohort 1 are associated with self-harm (IR: 8.20, 95%CI: 7.68-8.74), assault (IR: 6.46, 95%CI: 6.01-6.94), and falls (IR: 5.35, 95%CI: 4.93-5.79) (all p<0.001 compared to cohort 2).

Poster Abstracts

Conclusions: Elevated rates of intentional and unintentional injury among HIV+ individuals have been identified. While overall rates have decreased over time, disparities in the incidence of unintentional injury in this population remain. Future research will identify risk factors for injury and examine trends by sex, age, and injecting drug use status.

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CROI 2015