CROI 2017 Abstract e-Book

Abstract eBook

Poster and Themed Discussion Abstracts

Conclusion: Since introduction of cART, risk of death decreased and causes of death changed. We do not find evidence that HIV-positive individuals with a low CD4 count are more likely to die from cardiovascular diseases.

632 ASSOCIATIONS BETWEEN HIV CONTROLLER STATUS AND SUBCLINICAL CAROTID ATHEROSCLEROSIS

Rebeccah McKibben 1 , David B Hanna 2 , Sabina Haberlen 3 , Robert C Kaplan 2 , Frank J Palella 4 , Elizabeth T Golub 1 , Peter Bacchetti 5 , Ruth Greenblatt 5 , Todd Brown 6 , Wendy Post 1 1 Johns Hopkins Univ, Baltimore, MD, USA, 2 Albert Einstein Coll of Med, Bronx, NY, USA, 3 Johns Hopkins Bloomberg SPH, Baltimore, MD, USA, 4 Northwestern Univ, Chicago, IL, USA, 5 Univ of California, San Francisco, San Francisco, CA, USA, 6 Johns Hopkins Univ, Baltimore, MD, USA Background: Heightened immune activation among HIV-infected persons may contribute to atherosclerosis. In the absence of antiretroviral therapy (ART), HIV controllers (HC) maintain viral suppression yet exhibit enhanced immune activation compared with HIV-uninfected (HIV-) and ART-treated HIV-infected (ART-HIV+) individuals. We compared the presence of subclinical carotid atherosclerosis among HIV controller populations with that among ART-HIV+ and HIV- participants of the Multicenter AIDS Cohort Study (MACS) and Women’s Interagency HIV Study (WIHS). We hypothesized that HC would exhibit a greater prevalence of atherosclerosis compared to HIV- individuals. Methods: B-mode carotid artery ultrasound was performed on MACS and WIHS participants. HC were defined as 1) viremic controllers (VC, HIV RNA ≤2,000 copies/mL for ≥2 years not on ART) or 2) long-term non-progressors (LTNP) (CD4+ T-cell counts ≥500 cells/μL for ≥5 years not on ART). Participants who ever satisfied the definition of HC were included in this category, even if they no longer met criteria when imaged. Prevalence of plaque was compared between HC, HIV+ (± detectable viremia) and HIV- individuals (reference) using Poisson regression with robust standard errors adjusting for age, race/ethnicity, income, education, center, alcohol use, smoking, BMI, diabetes, systolic blood pressure, total and HDL cholesterol, hypertensive and cholesterol medications. Results: 3046 (2051 HIV+, 955 HIV-) men and women were studied, including 144 VC and 140 LTNP. Of the VC, 23%were EC and 45% also met the definition of LTNP. There was no statistically significant difference in the presence of carotid plaque between HIV controllers and HIV- individuals (VC prevalence ratio [PR] 0.97, 95% confidence interval [CI] 0.66-1.42; LTNP PR 1.06, CI 0.76-1.49), and a marginally statistically significant difference between HIV+ individuals without detectable viremia and HIV- individuals (PR 1.22, CI 0.998-1.48). In contrast, HIV+ individuals with detectable viremia more frequently had carotid plaque (PR 1.37, CI 1.06-1.79) compared to HIV- individuals. Conclusion: The presence of subclinical carotid artery atherosclerosis among viremic controllers or LTNP was similar to that of HIV- individuals. However, HIV+ individuals with detectable viremia were substantially more likely to have carotid plaque. These results indicate that uncontrolled viremia likely plays an important role in development of atherosclerosis in HIV infection.

Poster and Themed Discussion Abstracts

633 ASSOCIATION BETWEEN CARDIOVASCULAR EVENTS AND HIV-SPECIFIC RISK FACTORS Stefan Esser 1 , Norbert H. Brockmeyer 2 , Martin Hower 3 , Volker Holzendorf 4 , Christina Schulze 5 , Marina Arendt 5 , Till Neumann 6 , Nico Reinsch 7 , for the HIV HEART Study Group

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