CROI 2016 Abstract eBook

Abstract Listing

Poster Abstracts

Conclusions: Among a diverse global population of HIV+ persons with high CD4 counts, early ART initiation had increased LDL-C and the prevalence of dyslipidemia. However, concurrent increases in HDL-C and other mixed effects resulted in no consistent differences in CVD risk scores over time. These randomized data suggest that early ART has both positive and negative influences on CVD risk among HIV+ individuals with preserved immunity.

660

Cardiovascular Biomarkers After Switch to ABC/DTG/3TC: The STRIIVING Study Jordan Lake 1 ; Judith S. Currier 1 ; Justin Koteff 2 ; Clare Brennan 2 ; Catherine Granier 3 ; Mark Shaefer 2 ; Martin Gartland 2 ; BrianWynne 4 ; Michael Aboud 5 1 David Geffen Sch of Med at Univ of California Los Angeles, Los Angeles, CA, USA; 2 ViiV Hlthcare, Research Triangle Park, NC, USA; 3 GSK, Middlesex, UK; 4 ViiV Hlthcare, Collegeville, PA, USA; 5 ViiV Hlthcare, Brentford, UK Background: Improvements in inflammatory biomarker profiles have been documented in virologically-suppressed patients switching from PI and/or NNRTI to RAL and EVG. Because improvements in chronic inflammation may affect mortality and co-morbid disease development, we evaluated the effects of switch to ABC/DTG/3TC on markers of inflammation and immune activation. Methods: Participants were randomized 1:1 to switch to ABC/DTG/3TC or continue current suppressive (HIV-1 RNA <50 copies/mL) ART for 24 weeks. C-reactive protein (hs-CRP), interleukin-6 (IL-6), D-dimer, soluble vascular cell adhesion molecule (sVCAM), soluble CD14 and CD163 (sCD14, sCD163), and intestinal fatty acid binding protein (I-FABP) were measured as secondary endpoints on cryopreserved specimens using standardized assays. Mean 24-week changes in log-transformed biomarker values were compared between participants switching ABC/DTG/3TC vs continued suppressive ART using analysis of covariance (ANCOVA). No statistical adjustment for multiple comparisons was made. Results: Participants (274 switched to ABC/DTG/3TC, 277 continued current ART) were 86%male, 28% African American and had median age 45 years, CD4 + T lymphocyte count 610 cells/mm 3 and median time on ART 4.4 years. At entry, ART use was 42% PI, 31% NNRTI, 26% RAL or EVG, 77% tenofovir and 23% abacavir. After 24 weeks, mean changes in hs-CRP, IL-6, D-dimer, sVCAM and sCD163 were similar between participants switching to ABC/DTG/3TC and continuing current ART; however, greater declines in I-FABP and sCD14 were observed among participants switching to ABC/DTG/3TC (p<0.05), some of whom switched from RAL and EVG. Conclusions: Switch to ABC/DTG/3TC was associated with greater declines in sCD14 and I-FABP levels, even among participants switching from other integrase inhibitors. These changes may suggest reduced microbial translocation and monocyte activation following switch to ABC/DTG/3TC, which could have important implications for morbidity and mortality. Additionally, no worsening of markers associated with cardiovascular disease were observed following switch to ABC/DTG/3TC.

Poster Abstracts

271

CROI 2016