CROI 2017 Abstract e-Book

Abstract eBook

Poster and Themed Discussion Abstracts

Results: We enrolled 263 HIV/HBV-coinfected patients in Mozambique and Zambia. Mozambican participants were more likely to be female (61% vs. 41%, p<0.01), to have a moderate-severe anaemia (16% vs. 6%, p=0.03) and had higher median ALT (31 UI/l vs. 23UI/l, p=0.04) and CD4 cell counts (232/µl vs. 208/µl, p=0.03) compared to Zambia. The predominant HBV genotype was A1 in Mozambique (68%) and E (50%) in Zambia. The proportion of patients with an HBV viral load > 20.000 UI/ml was similar across sites (52% vs 45%, p=0.10). Over the first year on ART, median MPR was lower in Mozambique compared to Zambia (62% vs. 100%, p<0.01). At 1 year, after the systematic tracing of patients LTFU, vital status was unknown in only one patient (1.3%) in Mozambique and 7 patients (3.8%) in Zambia. One-year mortality was 16 % in Mozambique and 8% in Zambia (p=0.06) (Fig.1). In adjusted analyses, low BMI, moderate/severe anaemia and male sex were independent risk factors for mortality. Mortality was similar by genotype and by baseline HBV VL. Conclusion: Early mortality of HIV/HBV-coinfected individuals on ART is very high in SSA, especially in rural settings, where access to care and treatment adherence may be reduced.

Poster and Themed Discussion Abstracts

582 EFFECTIVENESS OF HAV VACCINATION AMONG HIV-POSITIVE PATIENTS DURING AN HAV OUTBREAK Kuan-Yin Lin 1 , Szu-Min Hsieh 1 , Hsin-Yun Sun 1 , Yi-Chun Lo 2 , Wang-Huei Sheng 1 , Yu-Chung Chuang 1 , Sung-Ching Pan 1 , Chien-Ching Hung 1 , Shan-Chwen Chang 1 1 Natl Taiwan Univ Hosp, Taipei, Taiwan, 2 Taiwan Cntrs for Disease Control, Taipei, Taiwan Background: An unprecedented outbreak of acute hepatitis A virus (HAV) infection has been occurring among men who have sex with men (MSM) in Taiwan since June 2015, with more than 750 cases reported to the Taiwan Centers for Disease Control as of 23 September, 2016. We evaluated the effectiveness and serologic response of HAV vaccination in HIV-positive patients in this outbreak setting. Methods: From June 2015 to September 2016, testing for HAV antibodies were prospectively performed for all HIV-positive patients and HAV-seronegative patients were advised to receive 2 doses of HAV vaccines (HAVRIX® or VAQTA®) at an interval of 6 months between the two doses. The primary endpoint of this study was serologic response 4 weeks after the last dose of vaccination and acquisition of acute HAV infection during the follow-up. The secondary endpoint was serologic response at week 48 of vaccination. Results: During the study period, 1574 HAV-seronegative patients were included, with 94.5% being MSM and median CD4 count 568 cells/mm3. As of 23 September 2016, 1037 patients (65.9%) had received at least one dose of HAV vaccine and 537 (34.1%) declined to receive vaccine; 303 (19.3%) had completed the 2-dose vaccine series. The seroconversion rate at 4 weeks, weeks 5-8, weeks 9-16, and weeks 17-24 was 15.8% (65/411), 25.9% (42/162), 50.3% (86/171), and 50.4% (130/258), respectively. One month after the last dose, the seroconversion rate increased to 94.7%. The factors associated with seroconversion between the first and last doses of HAV vaccination were receiving VAQTA® (adjusted odds ratio [AOR], 2.3; 95% CI, 1.5-3.5), time to anti-HAV IgG testing (AOR, per 1-week increase, 1.1; 95% CI, 1.1-1.2) and previous HAV vaccination (AOR, 32.3; 95% CI, 11.9- 87.7). With a total observation duration of 421.5 and 411.5 person-years of follow-up (PYFU), the incidence rate of acute HAV infection in patients without receiving HAV vaccine and those receiving at least 1 dose of HAV vaccine was 11.6 and 0.7 per 100 PYFU, respectively, resulting in vaccine effectiveness of 93.6%. The factors associated with acquisition of acute HAV infection included having not received HAV vaccine (adjusted hazard ratio [AHR], 33.3; 95% CI, 8.9-93.6) and recent syphilis (AHR, 4.7; 95% CI, 2.7-8.3). Conclusion: Despite the delayed serologic response to HAV vaccination in HIV-positive MSM, the risk of acute HAV infection was significantly reduced by HAV vaccination during the outbreak setting. 583 ACTIVE HPGV-2 INFECTION IS RESTRICTED TO COCIRCULATING HCV INFECTION Kelly Coller , Michael Berg, Matthew Frankel, Kenn Forberg, John Hackett, Gavin Cloherty, George Dawson Abbott Labs, Abbott Park, IL, USA Background: A second human Pegivirus (HPgV-2) was recently identified that is extensively associated with HCV infection. In contrast, the distantly related Pegivirus, GBV-C (HPgV-1) circulates in the general population, with a higher prevalence in HCV and HIV infected individuals. Although the clinical relevance of HPgV-2 infection is not understood, the virus appears to develop a chronic infection in 1% of HCV viremic individuals. We developed molecular and serologic tools to screen 4346 donor samples (volunteer donor, HCV-, HBV-, HIV-infected) for HPgV-2. All 24 strains identified have been isolated from active or resolved HCV infections. Methods: Serologic assays were developed using two HPgV-2 proteins, NS4AB and E2 for high-throughput screening on the Abbott ARCHITECT. Additionally, a serologic test using the envelope glycoprotein E2 of HPgV-1 was developed for comparison. Samples reactive to either HPgV-2 antigen were screened for viral RNA using a multiplex qPCR assay with 2 targets in HPgV-2 and 1 target in HPgV-1 on the Abbott m2000 platform. HPgV-2 RNA positive samples were subjected to next generation sequencing for molecular characterization and phylogenetic analysis.

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