CROI 2016 Abstract eBook

Abstract Listing

Poster Abstracts

strategy of 2-week multi-disease community health campaigns (CHC), that included HIV testing, counseling and linkage to care, followed by home-based testing of CHC non-participants over 1-2 months. We measured stable adolescent HIV testing coverage and prevalence, and determined predictors of self-reported newly diagnosed HIV among

HIV+ adolescents, using multivariable logistic regression and accounting for clustering by household. Results: HIV testing was achieved in 86,421 (88%) stable adolescents using a hybrid strategy; testing coverage was 86%, 90%, and 88% in early (10-14 years), mid (15-17) and late (18-24) adolescents, respectively. Self-reported prior HIV testing was 9%, 24%, and 50% in early, mid and late adolescents who tested for HIV, respectively. HIV testing coverage and prevalence by age are shown in Figure. In early, mid and late HIV+ adolescents, 61%, 69% and 56% reported newly diagnosed HIV, respectively. Overall, 51% of newly diagnosed HIV+ adolescents reported ever having a prior HIV test. In multivariate analysis of HIV+ adolescents, predictors of newly diagnosed HIV included male gender (OR=1.97 [95% CI: 1.42-2.73]), Ugandan residence (OR=2.63 [95% CI: 2.08-3.31]), and single marital status (OR=1.62 [95% CI: 1.23-2.14] vs. married). Conclusions: A hybrid mobile HIV testing strategy achieved significant increases in stable adolescent testing coverage to 88% compared to self-reported prior testing. The high proportion of HIV+ adolescents with newly diagnosed HIV (>50%) is likely due to a combination of increasing HIV risk with age and inadequate prior testing. Community-based, mobile testing initiatives to reach 90% of HIV+ adults can and should be leveraged to test adolescents and offer combination HIV prevention services.

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Weak HIV Antibody Responses in Perinatally Infected Young Adults Allison R. Kirkpatrick 1 ; Aylin Unsal 2 ; Joel N. Blankson 3 ; Richard Moore 4 ;Thomas C. Quinn 3 ; Colleen Hadigan 2 ; Oliver Laeyendecker 5

1 NIAID, NIH, Baltimore, MD, USA; 2 NIAID, NIH, Bethesda, MD, USA; 3 Johns Hopkins Univ Sch of Med, Baltimore, MD, USA; 4 Johns Hopkins Univ, Baltimore, MD, USA; 5 NIH, Bethesda, MD, USA Background: Young adults who acquired HIV infection perinatally comprise a significant proportion of HIV-infected individuals in some populations. These individuals are often misclassified as recently infected by age-based HIV prevalence models. There is little information characterizing the antibody response to HIV in perinatally-infected adults. Weak antibody responses could impact the performance of serologic assays used for HIV incidence estimation. We compared serologic characteristics in young adults with perinatally- acquired HIV infection (PN) to two groups who were infected as adults who are frequently misclassified as recently infected using cross-sectional HIV incidence assays: elite controllers (EC) and adults exposed to antiretroviral therapy (ART). Methods: Samples were obtained from adults living in the Baltimore-Washington area. (1) PN group: 225 samples from 22 adults perinatally-infected between 1984 and 1996; mean age: 20 years, range: 12-30; 159 samples had viral loads (VL) <400 copies/ml, none had suppressive therapy at birth and were exposed to multiple years of non-suppressive sequential monotherapy. (2) ART group: 480 samples from 379 adults exposed to ART; 290 samples had VL <400 copies/ml, mean minimal duration of infection 13 years, range: 8 to 25 years. (3) EC group: 40 samples from 21 adults. Samples were tested with the Limited Antigen Avidity Assay (LAg-Avidity) and an avidity modified version of the Genetic Systems 1/2 + O EIA (BioRad). Results: The PN group had higher frequency of samples with low LAg-Avidity and low BioRad results than the ART and the EC groups, see table. When comparing the PN to ART group stratified by viral suppression status, PN samples were more likely to have low LAg-Avidity and BioRad values. For VL<400 copies/ml, LAg-Avidity <1.5 OD-n: PN 73/159 vs. ART 25/290, P<0.001 and BioRad AI <80%: PN 46/159 vs. ART 3/290, P<0.001. Among VL>400 copies/ml, LAg-Avidity <1.5 OD-n: PN 3/66 vs. ART 2/190, P=0.11 and BioRad AI <80%: PN 5/66 vs. ART 0/190, P=0.001. Conclusions: Young adults infected perinatally were more likely to be misclassified by incidence assays than their counterparts who were infected as adults. These results could impact the precision of HIV incidence estimates in studies using these assays to analyze populations that include perinatally-infected adults. Further studies are needed to determine reason for the reduced antibody responses in these individuals.

Poster Abstracts

831 Incidence of Virologic Rebound in Perinatally HIV-Infected Adolescents on Stable cART Tavitiya Sudjaritruk 1 ; Linda Aurpibul 2 ; Saramony Sarun 3 ;Thoa P. Le 4 ;Torsak Bunupuradah 5 ; Rawiwan Hansudewechakul 6 ; Pagakrong Lumbiganon 7 ; Kulkanya Chokephaibulkit 8 ; Azar Kariminia 9 ; for theTREAT Asia Pediatric HIV Observational Database (TApHOD) 1 Johns Hopkins Bloomberg Sch of PH, Baltimore, MD, USA; 2 Rsr Inst for Hlth Scis Chiang Mai Univ, Chiang Mai, Thailand; 3 Univ of Hlth Scis Cambodia, Phnom Penh, Cambodia; 4 Children’s Hosp 1, Ho Chi Minh City, Vietnam; 5 HIV-NAT, Thai Red Cross AIDS Rsr Cntr, Bangkok, Thailand; 6 Chiang Rai Prachanukroh Hosp, Chiang Rai, Thailand; 7 Srinagarind Hosp, Khon Kaen Univ, Khon Kaen, Thailand; 8 Siriraj Hosp, Mahidol Univ, Bangkok, Thailand; 9 Kirby Inst, Sydney, Australia Background: With combination antiretroviral therapy (cART), survival of perinatally HIV-infected children has dramatically improved. Yet, maintaining successful treatment during adolescence is challenging. This study aimed to assess the incidence and predictors of virologic rebound among adolescents on cART with previously undetectable virus levels. Methods: Perinatally HIV-infected Asian adolescents (age 10-19 years) followed in the TREAT Asia Pediatric HIV Observational Database who were on cART and had a period of virologic suppression (two consecutive HIV RNA <400 copies/ml >6 months apart) before or during adolescence were included in the analysis. Baseline was the date of the first HIV

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CROI 2016