CROI 2016 Abstract eBook

Abstract Listing

Poster Abstracts

690 Soluble CD163 Predicts Incident Chronic Lung and Kidney Disease in HIV-1 Infection Ditte M. Kirkegaard-Klitbo 1 ; Niels Mejer 2 ;Troels Bygum Knudsen 3 ; Holger J. Møller 4 ; Søren K. Moestrup 4 ; Susanne D. Nielsen 1 ; Gitte Kronborg 2 ;Thomas Benfield 2 1 Rigshospitalet, Univ of Copenhagen, Copenhagen, Denmark; 2 Hvidovre Hosp, Univ of Copenhagen, Hvidovre, Denmark; 3 Hillerød Hosp, Univ of Copenhagen, Hillerød, Denmark; 4 Aarhus Univ Hosp, Aarhus Nord, Denmark Background: Despite the success of antiretroviral therapy (ART), HIV infection is still associated with an increased risk of comorbidity compared to that of the background population. We recently showed that plasma soluble CD163 (sCD163), a marker of monocyte/macrophage activation, was associated with all-cause mortality. Here we hypothesized that elevated sCD163 may predict non-AIDS comorbidity in HIV-infected individuals. Methods: Prospective single-center cohort study (n = 933). Plasma sCD163 was quantified at study entry in 2004/05. Comorbidity (cancer, cardiovascular disease (CVD), diabetes, and kidney, liver and lung diseases) was identified by ICD-10 diagnosis codes and registry linkage. Associations between sCD163 and incident comorbidity was examined using multivariable Cox proportional hazards models adjusted for age, sex, race, transmission category, prior comorbidity, CD4 T lymphocyte count, HIV RNA, and ART. Results: Median age of study participants was 43 years, 72%were men, 79%were white, and 86%were on ART. At baseline, 19% had comorbidity. During 10.5 years of follow up, there were 360 cases of incident non-AIDS comorbidity in 330 individuals. In multivariate analysis, highest quartile sCD163 concentration was associated with incident chronic lung disease (adjusted hazard ratio (aHR), 3.20; 95% confidence interval (CI): 1.41 to 7.24) and incident chronic kidney disease (aHR, 8.43; 95% CI: 1.73-41.01), when compared with lowest quartiles. sCD163 level was not associated with incident cancer, CVD, diabetes, or liver disease. Conclusions: These results suggest that monocyte/macrophage activation may be involved in the pathogenesis of HIV-associated lung and kidney disease. Measuring sCD163 may identify HIV infected patients at risk for chronic lung and kidney disease.

Poster Abstracts

691 Use of Urine Biomarker-Derived Clusters to Predict CKD Risk and All-Cause Mortality Rebecca Scherzer 1 ; Haiqun Lin 2 ; Alison Abraham 3 ; HeatherThiessen-Philbrook 2 ; Chirag Parikh 4 ; MaryYoung 5 ; PhyllisTien 1 ;Vasantha Jotwani 1 ; Michael Shlipak 1 ; for theWomen’s Interagency HIV Study Investigators 1 Univ of California San Francisco, San Francisco, CA, USA; 2 Yale Univ Sch of PH, New Haven, CT, USA; 3 Johns Hopkins Bloomberg Sch of PH, Baltimore, MD, USA; 4 Yale Univ Sch of Med, New Haven, CT, USA; 5 Georgetown Univ Med Cntr, Washington, DC, USA Background: Individual urine biomarkers are associated with CKD incidence and all-cause mortality in the setting of HIV infection, but their combined utility for prediction remains unknown. Methods: We measured 8 urine biomarkers in 902 HIV+ women: NAG, KIM-1, alpha 1 microglobulin (α1m), IL-18, NGAL, ACR, L-FABP, and AAG. A group-based cluster method classified each participant into 3 distinct clusters using the three most distinguishing markers (NAG, KIM-1, and α1m). We evaluated associations of each cluster with incident CKD (defined as eGFRcys<60) and all-cause mortality, adjusting for traditional and HIV-related risk factors. Results: Over 8 years of follow-up, 177 CKD events and 128 deaths occurred. As shown in the Table, incidence of CKD and mortality increased incrementally across the 3 clusters. After multivariable adjustment, cluster 3 remained associated with a nearly 3-fold risk of both outcomes compared with cluster 1. Addition of the clusters to the multivariable

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CROI 2016