CROI 2016 Abstract eBook

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Poster Abstracts

Methods: We performed a cross-sectional study of participants in the Women’s Interagency HIV Study (n=1,957) and Multicenter AIDS Cohort Study (n=2,514) who had anthropometric data available. Viral hepatitis was defined by positive hepatitis B virus (HBV) surface antigen and/or hepatitis C virus (HCV) RNA. We evaluated the prevalence of LMM, defined as <10 th percentile of age- and sex-matched reference values for mid-upper arm circumference, by HIV/viral hepatitis status. Using multivariable logistic regression, we determined adjusted odds ratios (ORs) with 95% confidence intervals (CIs) of: 1) LMM associated with viral hepatitis coinfection; and 2) factors associated with LMM in coinfected persons. Results: A total of 332 HIV/viral hepatitis-coinfected (246 HCV; 79 HBV; 7 HBV/HCV), 1,854 HIV only, 223 viral hepatitis only, and 2,061 uninfected patients were identified. LMM was most common in coinfected (24%), followed by HIV-monoinfected (14%), and least common in hepatitis-monoinfected and uninfected persons (both 10%) (all p<0.001 vs. coinfected). After adjustment for age, alcohol use, injection drug use (IDU), and body mass index, viral hepatitis was associated with LMM in HIV-infected women (OR 3.14 [1.79-5.51]); the association did not reach significance in men (OR 1.30 [0.68-2.13]). Results were similar after exclusion of cirrhotic patients. In coinfected women, IDU (OR 4.02 [1.11-14.53]), but not hazardous alcohol (OR 0.89 [0.43-1.82]), was associated with LMM; and, there was little association of liver aminotransferases >40 U/L (OR, 2.08 [0.93-4.65]) or glomerular filtration rate<60 ml/min (OR 1.57 [0.52-4.70]. Conclusions: Lowmuscle mass was more common in coinfected than HIV-monoinfected, hepatitis-monoinfected, and uninfected persons. In HIV, viral hepatitis was more strongly associated with lowmuscle mass in women than men. Future studies should determine if coinfection creates a heightened inflammatory state that promotes loss of muscle mass and explore reasons for the differential association by sex. 610 Rapid Improving of Glycemic Control in HCV Patients TreatedWith IFN-Free Regimens Paolo Pavone ;TizianaTieghi; Gabriella D’Ettorre; Miriam Lichtner; Raffaella Marocco; Ivano Mezzaroma; Giulia Passavanti; Claudio M. Mastroianni;VincenzoVullo Sapienza Univ of Rome, Rome, Italy Background: HCV infection has been widely associated with insulin-resistance and type 2 diabetes. Improved diabetic outcomes have been demonstrated many years after the HCV eradication, but development of type 1 diabetes has been reported following IFN exposition. Little is known about the impact of new direct acting antiviral agents (DAAs) on glycemic control. Methods: We retrospectively evaluated 29 HCV-infected patients (10 HIV+) with type 2 diabetes who were treated with different IFN-free regimens, including sofosbuvir, simeprevir, ledipasvir, daclatasvir, dasabuvir and ombitasvir/paritaprevir/ritonavir. To evaluate general improving of glycemic control, we used a composite endpoint given by reduction of fasting glucose (FG) (of min. 20 mg/dl) or glycated haemoglobin (A1C) (of min. 0.5%) or reduction of insulin/metformin dosing during anti-HCV treatment. Statistical analysis was performed with the paired t-test, Kruskal-Wallis test and Welch one-way ANOVA procedure (R software). Results: The mean age of the patients was 59,28 years (24 M, 5 F). All the patients had HCV-RNA undetectable at end of treatment (or <15 UI/ml if still on treatment). Pre- treatment FG was reported in 27 patients, mean value 175 mg/dl (range, 85-455), pre-treatment A1C in 17 patients, mean value 7.1% (range, 5.1%-11.8%). FG during treatment was available for 21 patients and analysis showed a statistically significant reduction (p=0,007), reduction mean value was -52,86 mg/dl [Fig.1]. A1C during treatment was available for 10 patients and analysis showed a statistically significant reduction (p=0,021), reduction mean value was -1,95%. 4 patients were excluded from the analysis cause data were insufficient. The endpoint was reached by 21 of 25 patients (84%). 6 patients (23%) needed to reduce insulin dosing, 8 of 10 patients showed reduction of A1C, 14 of 21 patients (67%) showed reduced FG during treatment. FG and A1C reductions were independent from the drug used, HCV genotype and HIV. No cases of symptomatic hypoglycaemia were found. Between the 4 patients who didn’t reach the endpoint 3 presented normal baseline FG (<110 mg/dl) and A1C (<6%) and the remaining 1 presented Child-Pugh B and was the only patient with persisting elevated liver enzymes at end of treatment. Conclusions: HCV suppression following DAA treatment is associated with rapid improving of glycemic control. In order to avoid ipoglycemic events, patients undergoing DAAs should be closely monitorized for reduction of hypoglycaemic drugs.

Poster Abstracts

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Eradication of HCV and Extrahepatic Comorbidities in HIV/HCV Coinfection Juan Berenguer 1 ; Miguel A.VonWichmann 2 ; José López-Aldeguer 3 ; María J. Galindo 4 ; Josep Mallolas 5 ; Manel Crespo 6 ; María J.Tellez 7 ; José M. Bellón 1 ; Juan González-García 8 ; for the GeSIDA 3603 Study Group 1 Hosp General Universitario Gregorio Marañón, Madrid, Spain; 2 Hosp Universitario Donostia, San Sebastián, Spain; 3 Hosp Universitari i Politècnic La Fe, Valencia, Spain; 4 Hosp Clínico Universitario de Valencia, Valencia, Spain; 5 Hosp Clínic de Barcelona, Barcelona, Spain; 6 Hosp Universitari Vall d’Hebron, Barcelona, Spain; 7 Hosp Clinico San Carlos, Madrid, Spain; 8 Inst for Hlth Rsr of La Paz Univ Hosp, Madrid, Spain Background: We studied the effect of SVR on non–liver-related (NLR) non–AIDS-related (NAR) events and mortality in HIV/HCV+ patients (Pts) after therapy with interferon plus ribavirin (IR). Methods: GeSIDA 3603 is a cohort of HIV/HCV+ Pts treated with IR between 2000-2008 in 19 centers. We assessed incident NLR-NAR events from interruption of IR to the last follow-up visit, death, or loss to follow-up. Pts were classified as responders (including those who achieved SVR after retreatment) or nonresponders. We assessed NLR-NAR deaths and NLR-NAR events, including cardiovascular events (myocardial infarction, angina, stroke, peripheral artery disease, heart failure, ruptured aortic aneurism, and mesenteric

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