CROI 2016 Abstract eBook

Abstract Listing

Poster Abstracts

823 Long-term Effects on Basal Ganglia in YouthWith Perinatally Acquired HIV Infection Christine Paula de los Angeles 1 ; Paige L.Williams 2 ;Yanling Huo 2 ; Kathleen Malee 3 ; John G. Csernansky 1 ; RamYogev 3 ; Russell B.Van Dyke 4 ; Elizabeth R. Sowell 5 ; LeiWang 1 ; for the Pediatric HIV/AIDS Cohort Study (PHACS) 1 Northwestern Univ, Feinberg Sch of Med, Chicago, IL, USA; 2 Harvard Sch of PH, Boston, MA, USA; 3 Ann and Robert H. Lurie Children’s Hosp of Chicago, Chicago, IL, USA; 4 Tulane Univ Sch of Med, New Orleans, LA, USA; 5 Keck Sch of Med at the Univ of Southern California, Los Angeles, CA, USA Background: HIV affects multiple brain regions. Pathological studies have demonstrated prominent and differential distribution patterns of HIV load in the basal ganglia. Neuroimaging studies in adults have also implicated these subcortical structures for HIV prognosis demonstrating a correlation between atrophy and clinical measures of disease severity. Whether these effects are observed in adolescents with perinatally-acquired HIV (PHIV) has not been well-studied. Methods: We conducted structural magnetic resonance imaging (MRI) in 40 youth with PHIV (median age=17.1 years, 48%male) at one PHACS Adolescent Master Protocol study site. Current and past HIV severity measures were obtained frommedical charts. Median peak HIV-1 RNA load was 522,000 copies/ml. Median nadir CD4+ T-lymphocyte percentage was 17%. Subcortical surfaces and vertex deformation referenced to a population mean for each region of the basal ganglia (nucleus accumbens, caudate, putamen and globus pallidus) as well as the hippocampus, amygdala and thalamus were obtained via automated FreeSurfer-initiated Large-Deformation Diffeomorphic Metric Mapping (FSLDDMM) pipeline. Principal component analysis (PCA) was performed for each region on the deformation covariance for dimensionality reduction, and components accounting for 75% of the variance were used to quantify subcortical shape. These PCA-based shape measures were evaluated for association with peak HIV-1 RNA viral load and nadir CD4+ T-lymphocyte percentage, adjusting for sex, age, and substance use. Significant associations were then visualized on the specific surfaces using vertex deformation data. Results: Peak viral load showed significant correlations with the shape of the left putamen, globus pallidus, caudate, and thalamus (all p<0.001), but not with right basal ganglia structures. Visualization revealed that higher peak viral load was associated with increased inward deformity (i.e., localized volume loss) in contiguous patterns, primarily in anterior and posterior aspects of these structures (Figure). No association with nadir CD4 lymphocyte percentage was observed. Conclusions: PHIV youth with a history of higher peak viral loads were associated with greater localized volume loss in multiple regions of the basal ganglia. These neuroimaging findings are consistent with histopathologic and clinical studies in adults, and suggest similar patterns of brain dysmorphology in adolescents with life-long HIV given antiretroviral therapy during brain development.

Poster Abstracts

824 Risk Factors for BCG IRIS in HIV-Infected Infants Starting Antiretroviral Treatment Varghese K. George 1 ; Elisa Nemes 2 ; AsmaToefy 2 ;Willem Hanekom 2 ; Mark F. Cotton 3 ; Charles D. Mitchell 4 ; James Oleski 5 ; Bonnie Zimmer 6 ;Terry Fenton 7 ; Savita Pahwa 4 ; for the IMPAACT P1073 1 Univ of Miami, Miami, FL, USA; 2 Univ of Cape Town, Cape Town, South Africa; 3 Stellenbosch Univ and Tygerberg Children’s Hosp, Cape Town, South Africa; 4 Univ of Miami Miller Sch of Med, Miami, FL, USA; 5 New Jersey Med Sch, Newark, NJ, USA; 6 Frontier Sci & Tech Rsr Fndn, Inc, Amherst, MA, USA; 7 SDAC, Harvard Sch of PH, Boston, MA, USA Background: Bacille Calmette-Guerin (BCG) vaccine is widely used in Tuberculosis (TB) endemic, resource-limited settings, and is administered soon after birth. In HIV-infected infants, BCG related Immune reconstitution inflammatory syndrome (IRIS) is a complication of ART but its pathogenesis is uncertain.

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CROI 2016