CROI 2016 Abstract eBook

Abstract Listing

Poster Abstracts

patients respectively, achieved HIV RNA < 20 copies/mL and 52 (70%) HIV/HBV co-infected patients achieved HBV DNA < 116 copies/mL (lower limits of detection). In MV analyses, after adjusting for baseline LSM and other factors, female sex and higher baseline CD4 T-cell counts/mm 3 , were associated with LSM decline in all patients [F vs M: OR 3.9, (95% CI 1.2-13.3); p= 0.03; CD4 T-cell count, p=0.01] and HIV/HBV patients alone [F vs M: OR 9.0, (95% CI 1.6-48.8); p=.01; CD4 T-cell count, p <.01]. In HIV/HBV patients, HBV DNA level and HBeAg seropositive status were not associated with LSM decline. Conclusions: Fibrosis regression, as measured by TE, appears mainly associated with gender and immune status in HIV and HIV/HBV infected Nigerians. The association between higher CD4 counts and LSM declines supports earlier ART initiation in both patient groups. The impact of antiviral treatment and HBV suppression on fibrosis changes requires further investigation.

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Changes in Viral Hepatitis Screening Practices Over Time in African HIV Clinics Ahuatchi P. Coffie 1 ; Matthias Egger 2 ; MichaelVinikoor 3 ; Marcel Zannou 4 ; Lameck Diero 5 ; Akouda Patassi 6 ; Ponsiano Ocama 7 ; Francois Dabis 8 ; GillesWandeler 2 1 Prog PACCI, CHU Treichville, Abidjan, Côte d’Ivoire; 2 Univ Hosp Bern, Bern, Switzerland; 3 Cntr for Infectious Disease Rsr in Zambia, Lusaka, Zambia; 4 Cntr de Prise en Charge des Personnes Vivant Avec le VIH, CHNU, Cotonou, Benin; 5 Moi Univ, Eldoret, Kenya; 6 Univ Sylvanus Olympio, Lomé, Togo; 7 Makerere Univ Coll of Hlth Scis, Kampala, Uganda; 8 INSERM U897, ISPED, Univ de Bordeaux, Bordeaux, France Background: There is a major burden of HIV-hepatitis B virus (HBV) co-infection in sub-Saharan Africa and knowledge of HBV status is important to guide optimal selection of ART drug regimens. We aimed to describe changes in testing practices related to viral hepatitis over a 3-year period in HIV clinics in sub-Saharan Africa.

Methods: A medical chart review was conducted in 10 large urban HIV treatment centers in Côte d’Ivoire (3 sites), Burkina Faso, Bénin, Togo, Sénégal, Zambia, Kenya and Uganda (1 site each). Of the patients who started ART between 2010 and 2012, 100 per year were randomly selected from each clinic. Demographic, clinical and laboratory information were collected using a standardized questionnaire with a special focus on screening and management of HBV and hepatitis C virus (HCV) infections. We examined changes in the proportion of patients screened over time and identified predictors of testing in multivariable logistic regression models including sex, age, region (West, East and Southern Africa) and level of education (secondary/high school vs. lower). Results: A total of 2,981 patients were included (median age 37 years, 64.2% female). Overall, only 471 (15.8%) patients had been tested for HBV, increasing over the years (10.4% in 2010, 14.6% in 2011 and 22.9% in 2012, p<0.001) although there were large differences in uptake across countries (Figure). Overall, 73 (15.5%, 95% confidence interval [CI]: 12.3-19.1) were HBsAg-positive. In 86.6% of patients screened, the HBsAg assay was the only test implemented, and 70.9% of the tests were performed before ART initiation. The

Poster Abstracts

increase in HBV testing over time was largely due to programmatic changes and only 3.8% of tests were clinically-driven (elevated transaminases). In multivariable analysis, high education level (adjusted odds ratio 1.84, CI 1.47-2.30) and region (South vs. West: 1.43, CI 1.04-1.96; East vs. West: CI 1.17, 0.91-1.51) were associated with HBsAg screening. Among HBV-infected patients, 59 (80.9%) received tenofovir-containing ART. Only 30 (1.0%) patients were screened for HCV (19 in Senegal) and one of them (3.3%, 95% CI 0.84-17.2) was positive. Conclusions: Conclusion: Between 2010 and 2012, the systematic screening for HBV infection in HIV-positive patients before ART initiation was limited in many African countries and differed widely across clinics. The increasing availability of HBsAg rapid tests and tenofovir as part of first-line ART should encourage HIV programs to improve HBV.

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CROI 2016