CROI 2016 Abstract eBook

Abstract Listing

Poster Abstracts

859 Effects of Vitamin D Supplementation on BMD and Bone Markers in HIV+ Youth Allison R. Eckard 1 ; Ann Chahroudi 2 ; Julia C. Rosebush 2 ; Mary Ann O’Riordan 3 ; Julie E. Daniels 2 ; Monika Uribe-Leitz 2 ; Bruce Kinley 3 ; Danielle Labbato 3 ;VinTangpricha 2 ; Grace A. McComsey 3 1 Med Univ of South Carolina, Charleston, SC, USA; 2 Emory Univ Sch of Med, Atlanta, GA, USA; 3 Case Western Reserve Univ, Cleveland, OH, USA Background: Low bone mineral density (BMD) is a significant co-morbidity in HIV. Vitamin D supplementation in the general population improves BMD in those with vitamin D deficiency. In HIV, studies are limited and show conflicting data. Our study investigates changes in BMD and bone turnover markers after 12 months of supplementation in HIV+ youth with vitamin D insufficiency. Methods: This is a randomized, active-control, double-blind trial investigating 2 different monthly vitamin D 3 doses [60,000 (medium) or 120,000 (high) IU/month] vs. a control arm of 18,000 IU/month in 8-26 year old HIV+ youth on ART with baseline 25-hydroxyvitamin D (25(OH)D) ≤30 ng/mL and HIV-1 RNA <1000 copies/mL. Randomization was stratified by EFV use. Spine and total hip bone BMD by DXA and plasma bone turnover markers were measured at baseline (BL) and at 12 months. Comparisons of BMD and bone marker changes from BL to 12 months were made within each group, and between the HIV+ control dose vs. combined supplementation (medium+high dose) using appropriate two-sample tests. Results: Overall, 102 participants enrolled: 64%male, 89% black, median (Q1, Q3) age of 20 (17, 23) years. HIV & ARV duration were 8 (2, 17) and 3 (1, 10) years, respectively with a CD4 count of 652 (450, 871) cells/mm 3 . Only 26%were on EFV. BL 25(OH)D was similar between groups (control group: 17 (11, 21) vs. medium+high group: 18 (14, 22) ng/mL; P=0.49) and increased to 31 (22, 37) and 42 (33, 53) ng/mL in the control and supplementation (medium+high dose) groups at 12 months, respectively (within and between groups P<0.001). Over 12 months, HIV+ subjects in medium+high dose group had significant % increases in BMD at the spine (+2.8%, P=0.001) and hip (+0.9%, P=0.03). In the control dose group, increases were seen in % BMD for hip (+0.6%, P=0.002), but not spine (P=0.87). Osteocalcin, β-crosslaps, and procollagen type 1 N-terminal propeptide trended down in the medium+high group (P=0.046, 0.049, 0.053, respectively). None of the endpoints were significantly different between supplementation group (medium+high) and controls (P≥0.15). Changes in BMD seen in the medium+high dose group appeared to be driven by subjects in the medium dose group. Conclusions: BMD increased and bone turnover markers decreased in HIV+ youth with vitamin D insufficiency after 12 months of vitamin D supplementation. A dose of 60,000 IU/ month appeared to have the greatest impact on BMD. Vitamin D repletion with this dose should be studied further in deficient HIV+ youth.

860 Seroprevalence of Hepatitis B Among HIV-Infected Children and Adolescents in Asia Linda Aurpibul 1 ; Azar Kariminia 2 ;Vibol Ung 3 ; Moy Siew Fong 4 ; Oanh Ngoc Le 5 ; Rawiwan Hansudewechakul 6 ;Torsak Bunupuradah 7 ; Nia Kurniati 8 ; Pagakrong Lumbiganon 9 ; Tavitiya Sudjaritruk 10 ; for theTREAT Asia Pediatric HIV Observational Database (TApHOD) 1 Rsr Inst for Hlth Scis Chiang Mai Univ, Chiang Mai, Thailand; 2 Kirby Inst, Sydney, Australia; 3 Univ of Hlth ScisCambodia, Phnom Penh, Cambodia; 4 Hosp Likas, Kota Kinabalu, Malaysia; 5 Worldwide Orphans Fndn, Ho Chi Minh City, Vietnam; 6 Chiang Rai Prachanukroh Hosp, Chiang Rai, Thailand; 7 HIV-NAT, Thai Red Cross AIDS Rsr Cntr, Bangkok, Thailand; 8 Cipto Mangunkusumo General Hosp, Jakarta, Indonesia; 9 Srinagarind Hosp, Khon Kaen Univ, Khon Kaen, Thailand; 10 Johns Hopkins Bloomberg Sch of PH, Baltimore, MD, USA Background: Hepatitis B (HBV)-HIV coinfection is associated with liver inflammation which can progress to liver fibrosis/cirrhosis. We determined HBV seroprevalence in children and adolescents participating in the TREAT Asia Pediatric HIV Observational Database. Methods: A multi-site cross-sectional study was done among HIV-infected patients currently aged <25 years receiving antiretroviral treatment (ART) who had HBV surface antigen (HBsAg), HBV surface antibody (anti-HBs), and/or HBV core antibody (anti-HBc) tested during 2012-2013. HBV coinfection was defined as having positive HBsAg. Seroprotection was defined as having anti-HBs >10 mIU/mL. Isolated anti-HBc was defined as a positive anti-HBc test with negative HBsAg and anti-HBs tests. Results: A total of 3,380 patients from 6 countries (Vietnam, Thailand, Cambodia, Malaysia, Indonesia, and India) were enrolled; 96% had perinatal HIV-infection. The current median (interquartile ranges, IQR) age was 11.2 (7.8-15.1) years, and duration on ART was 5.9 (3.4-8.0) years. History of HBV vaccination was documented in 39% (1323/3380). Of the 2,754 patients with HBsAg testing (81.5%), 130 were positive, representing a prevalence of HBV coinfection of 4.7% (95% confidence interval [CI] 3.9-5.5). For patients with HBV-HIV coinfection, 50%were male, the median (IQR) age was 11.6 (8.1-14.7) years, the median (IQR) CD4 count was 806 (558-1172) cells/mm 3 , and 84% (49/58) had HIV RNA <400 copies/mL. Among 73% (95/130) with serum alanine transferase (ALT) available, 28 (29%) had mild to moderate elevated ALT to 1.25-5 times the upper limit of normal (xULN), while 3 (3%) had ALT > 5xULN. Of 1,093 patients with anti-HBs testing, 257 had positive tests. The prevalence of seroprotection was 23.5% (CI 21.0-26.0); with 30% (180/599) among those with documented history of HBV vaccination before ART, and 45% (120/267) among those revaccinated after immune recovery. Of the 1,036 patients with all three tests, 13 (1.3%) had isolated anti- HBc . Conclusions: The estimated prevalence of HBV coinfection in this cohort of Asian HIV-infected children and adolescents on ART was 4.7%. The majority of those with a history of early childhood or revaccination had insufficient levels of HBV protective antibody. HBV screening of HIV-infected children can guide use of ART with anti-HBV activity, and facilitate revaccination of those without seroprotection. 861 Correlates of Injectable Contraceptive Discontinuation Following HIV-1 Seroconversion Margaret R. Caplan 1 ; Jennie L. McKenney 2 ; Raphael J. Landovitz 1 ;Thesla Palanee-Phillips 3 ; Gonasagrie Nair 4 ; Felix Mhlanga 5 ; Jennifer E. Balkus 6 ; Sharon A. Riddler 7 ; Pamina Gorbach 8 1 David Geffen Sch of Med at Univ of California Los Angeles, Los Angeles, CA, USA; 2 Rollins Sch of PH, Emory Univ, Atlanta, GA, USA; 3 Wits Reproductive Hlth and HIV Inst, Johannesburg, South Africa; 4 Univ of KwaZulu-Natal, Durban, South Africa; 5 Univ of Zimbabwe, Univ of California San Francisco Collaborative Rsr Prog, Harare, Zimbabwe; 6 Fred Hutchinson Cancer Rsr Cntr, Seattle, WA, USA; 7 Univ of Pittsburgh, Pittsburgh, PA, USA; 8 Univ of California Los Angeles Sch of PH, Los Angeles, CA, USA Background: The risk of vertical HIV transmission during acute and recent HIV infection is elevated, highlighting the importance of effective contraception in addition to barrier methods during this period. While progestin-only injectable contraception (IC) is the most common highly effective contraceptive method currently used in sub-Saharan

Poster Abstracts

361

CROI 2016