CROI 2016 Abstract eBook

Abstract Listing

Poster Abstracts

Conclusions: In clinical practice, although LDV/SOF treatment failures are rare, they are growing in number. Liver cirrhosis and HCC may be risk factors. Information about patients who fail treatment may identify groups of patients who would benefit from a longer duration of therapy or a triple-drug regimen.

589 Dolutegravir and Outcome of HCV Therapy With Direct-Acting Antiviral Agents Stefan Mauss 1 ; Patrick Ingiliz 2 ; Dietrich Hueppe 3 ;Thomas Lutz 4 ; Karl Georg Simon 5 ; Knud Schewe 6 ; Christoph Boesecke 7 ; Guenther Schmutz 1 ; Axel Baumgarten 2 ; Stefan Christensen 8 1 Cntr for HIV and Hepatogastroenterology, Duesseldorf, Germany; 2 Med Cntr for Infectious Diseases, Berlin, Germany; 3 Practice for Gastroenterology Herne, Herne, Germany; 4 Infektiologikum, Frankfurt/Main, Frankfurt, Germany; 5 Practice for Gastroenterology Leverkusen, Leverkusen, Germany; 6 ICH Hamburg, Hamburg, Germany; 7 Univ Hosp Bonn, Bonn, Germany; 8 Cntr for Interdisciplinary Med, Muenster, Germany Background: Treatment with direct acting antivirals (DAA) is standard of care for HCV therapy in HIV-coinfected patients. Drug drug interactions are an issue with some of the antiretrovirals. Dolutegravir (DTG) is a widely used HIV integrase inhibitor with a promising drug drug interaction profile. However, use of DTG has been excluded from all phase 2 or 3 HCV/HIV-coinfection trials with DAAs. Methods: Analysis of the effect of antiretroviral drug class on outcome of HCV therapy and HIV suppression in a prospective cohort of chronic hepatitis C patients with and without HIV coinfection in Germany (GECCO). Patients were treated with sofosbuvir (SOF)/PegInterferon (PegIFN)/ribavirin (RBV), SOF/daclatasvir (DCV), SOF/ledipasvir (LDV) and paritaprevir/ritonavir/ombitasvir +/- dasabuvir. Fishers exact test was used for pairwise comparison (p<0.05). Results: For the analysis a total of 282 patients with HCV/HIV-coinfection were included. Most patients had a NRTI backbone as part of antiretroviral regimen (n=234). Distribution of drug classes were as follows: HIV-protease inhibitor (PI) n=83, raltegravir (RAL) n=86, DTG n=51, NNRTI n=92. 33 patients had no antiretroviral therapy. SVR12 data are available from 127 patients to date. There was no difference in SVR12 comparing patients with DTG as the third agent (n=26/28, SVR=93%) to RAL (n=35/40, SVR=88%), PI (n=26/29, SVR=90%) or NNRTIs (n=30/30, SVR=100%) (p=n.s.). No patient experienced a loss of control of HIV replication so far. No patient discontinued therapy due to adverse events. Conclusions: In this prospective cohort response to HCV therapy was excellent. DTV had no effect on the outcome of HCV therapy compared to other third agents used in antiretroviral therapy. Control of HIV therapy was maintained in all antiretroviral subgroups. An update from the cohort will be presented at the meeting. 590 Incidence/Deaths Related to Acute Hepatitis C in Spain: Impact of HIV/HCV Coinfection Alejandro Alvaro-Meca 1 ; Asuncion Diaz 2 ; Marta Sánchez-Carrillo 2 ; SoniaVázquez-Morón 2 ; Salvador Resino 2 ; Verónica Briz 2 1 Univ Rey Juan Carlos, Alcorcón, Spain; 2 Inst de Salud Carlos III, Madrid, Spain Background: To estimate the incidence of acute hepatitis C (AHC)-related hospital admissions and mortality, with particular attention to human immunodeficiency virus (HIV)/ hepatitis C virus (HCV) coinfected patients, as well as to analyze its trend along combination antiretroviral therapy (cART) era (1997-2012) in Spain. Methods: We carried out a retrospective study on patients with an AHC diagnosis in the Spanish Minimum Basic Data Set. Patients were classified as HCV-monoinfected patients and HIV/HCV-coinfected patients. The outcome variables were: i) AHC-related hospital admission (incidence); ii) AHC-related mortality (intra-hospital mortality). Results: Overall, 22684 patients were diagnosed with AHC during the study period, of which 18990 subjects were HCV-monoinfected and 3694 individuals were HIV/HCV- coinfected. The overall incidence of AHC-related hospital admission over 16 years of follow-up in HIV/HCV-coinfected patients was 1.9 per 1,000 person-year (p-y) while in HCV- monoinfected patients was 3.2 per 100,000 p-y (p<0.001). Besides, both groups showed a dramatic decrease in AHC-related hospital admissions (approximately 6-7 times) during study period (p<0.001). The overall mortality over whole follow-up in HIV/HCV-coinfected group was 1.0 per 10,000 p-y while in HCV-monoinfected group was 1.7 per 100,000 p-y (p<0.001). Additionally, AHC-related mortality diminished significantly in both groups (approximately 4-5 times) during study period (p<0.001). Overall, the adjusted likelihood of death for AHC was 2.50 (95%CI=2.07-3.02) times higher in HIV/HCV-coinfected patients than in HCV-monoinfected patients. Conclusions: HIV/HCV-coinfected individuals were at higher risk for hospital admissions and deaths related to AHC during the cART era, with higher incidence and mortality than HCV-monoinfected subjects. 591 Background: U.S. guidelines recommend Hepatitis A virus (HAV) vaccination for HIV-infected men who have sex with men (MSM) and persons who inject drugs (PWID) due to sexual and needle-sharing practices, respectively, that may lead to fecal-oral or percutaneous HAV transmission. However, nationally representative estimates of vaccine coverage and immunity for this population are lacking. Methods: We used medical record and interview data from the 2009–2012 cycles of the Medical Monitoring Project, a nationally representative surveillance system of U.S. HIV-infected adults in care, to estimate the prevalence of HAV immunity based on documentation of vaccination (defined as receipt of at least one vaccine dose) and anti-HAV antibodies among MSM and PWID. Interviews are conducted from June-April during each MMP cycle. Medical records are abstracted 12 months back from the data of interview. We used medical records and laboratory data available since the time of HIV diagnosis to estimate prevalence of HAV immunity 1) at the end of the 12 month follow-up period (ever), 2) Hepatitis A Virus Vaccination and Immunity Among At-Risk HIV-Infected Adults Nicholas P. DeGroote 1 ; Christine Mattson 1 ;YunfengTie 2 ; JohnT. Brooks 1 ; Shikha Garg 1 1 CDC, Atlanta, GA, USA; 2 ICF Intl, Atlanta, GA, USA

Poster Abstracts

235

CROI 2016