CROI 2016 Abstract eBook

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Poster Abstracts

artery ischemia), renal events (chronic renal failure, dialysis, and renal transplantation), bone events (bone fractures and avascular bone necrosis), diabetes mellitus, NLR-NAR– defining cancer, and NAR sepsis requiring hospitalization. NLR-NAR events were defined according to the Cohort of the Spanish AIDS Research Network (AIDS 2013; 27:181). The censoring date was May 31, 2014. All the centers were monitored before the analysis. We calculated the aHR (95%CI) of events in responders vs nonresponders by Cox regression analysis. The variables for adjustment were age, sex, prior AIDS, HIV risk group, nadir CD4+ cell count, cART, HIV-RNA load, HCV genotype, and advanced fibrosis (FIB4≥3.25). Competing risk survival analysis was applied when analyzing NLR-NAR events (overall death) and NLR-NAR death (AR or LR death). Two sensitivity analyses were carried out: one by censoring FU in retreated patients with SVR at the date of initiation of retreatment and the other by excluding those who were retreated. Results: Of 1,625 Pts, 592 (36%) had an SVR. After a median FU of 5.2 y in responders and 5.5 y in nonresponders, significantly lower frequencies and rates of renal events, diabetes mellitus, and NAR sepsis were seen in responders ( Table ). Cox regression analysis showed that the aHR of renal events and diabetes mellitus were significantly lower in responders ( Table ). These results were confirmed by the 2 sensitivity analyses. Conclusions: Our findings suggest that eradication of HCV in coinfected Pts is independently associated with a reduced hazard of renal events and diabetes mellitus. Eradication of HCV was not independently associated with a reduced hazard of NLR-NAR death, cardiovascular events, bone events, NLR-NAR cancers, or NAR sepsis.

612 Hepatitis C and the Risk of Non-Liver-Related Morbidity and Mortality in HIV+ Persons Helen Kovari 1 ; RainerWeber 1 ; Alexandra L. Calmy 2 ; Matthias Cavassini 3 ; Marcel Stoeckle 4 ; Patrick Schmid 5 ; Enos Bernasconi 6 ; Andri Rauch 7 ; Bruno Ledergerber 1 ; for the Swiss HIV Cohort Study 1 Univ Hosp Zurich, Zurich, Switzerland; 2 Univ Hosp Geneva, Univ of Geneva, Geneva, Switzerland; 3 Univ Hosp Lausanne, Univ of Lausanne, Lausanne, Switzerland; 4 Univ Hosp Basel, Basel, Switzerland; 5 Cantonal Hosp, St Gall, Switzerland, St Gall, Switzerland; 6 Regional Hosp Lugano, Lugano, Switzerland; 7 Bern Univ Hosp and Univ of Bern, Bern, Switzerland

Background: HCV infection has been associated with increased non-liver- related morbidity and mortality; however studies have yielded inconsistent results. Methods: The incidence of clinical events in four HCV-seropositive groups (untreated spontaneously cleared/detectable HCV-RNA, treated with/without sustained virologic response (SVR)) and matched HCV-seronegative Swiss HIV Cohort Study (SHCS) participants from 08/1994 to 12/2014 were studied. We compared HCV-seropositive to HCV–seronegative patients and aviremic to replicating HCV infection. Poisson regression was used to assess differences across these groups (see footnote in Figure). Results: We included 2503 HCV-seropositive individuals, 540 with cleared HCV infection, 1294 untreated viremic, 345 treated with SVR, 281 treated without SVR, and 2503 HCV-seronegative controls. After a mean follow-up of 8.2 years, we observed 107/18 (HCV-seropositive/HCV-seronegative) liver events, 41/14 kidney diseases, 230/121 osteoporosis/fracture, 114/129 cardiovascular events, 162/126 HIV CDC B/C events, 106/10 liver-related deaths and 227/218 non-liver-related deaths. Adjusted incidence rate ratios for the HCV-negative and different HCV-seropositive groups are shown in the Figure. Compared to HIV-monoinfected controls, HCV-seropositive groups combined had an increased risk of liver disease (IRR 6.29 [95% CI 3.52-11.22]), liver-related death (8.24 [3.61-18.83]), kidney events (2.43 [1.11-5.33]) and osteoporosis/fracture (1.43 [1.03-2.01]). No evidence for an association with increased risk was found for cardiovascular diseases, HIV CDC B/C events and non-liver-related death. Among HCV-seropositive individuals, those with replicating HCV infection had an increased risk of liver-related events compared to aviremic participants (untreated viremic vs cleared 2.84 [1.36-5.89]; non-SVR vs SVR 6.74 [1.36- 5.89]) and liver-related death (untreated viremic vs cleared 2.10 [0.99-4.47]; non-SVR vs SVR 3.36 [1.37-8.21]). Non-liver-related diseases and death did not significantly differ between HCV viremic vs aviremic patients. Conclusions: While incidence for non-liver-related death and cardiovascular events was not elevated, HCV exposure was associated with an increased risk of kidney disease and osteoporosis. This risk did not seem to be dependent of persistent HCV replication.

Poster Abstracts

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CROI 2016