CROI 2017 Abstract e-Book

Abstract eBook

Poster and Themed Discussion Abstracts

Poster and Themed Discussion Abstracts

668 VACS INDEX AS A PREDICTOR FOR NON-AIDS DEFINING CONDITIONS IN A LONGITUDINAL COHORT

Brian K. Agan 1 , Seung Hyun Won 1 , Christina Schofield 2 , Anuradha Ganesan 1 , Margaret Glancey 1 , Jason Okulicz 3 , Edmund C. Tramont 4 , Julie Pavlin 1 , for the IDCRP HIVWorking Group 1 Uniformed Services Univ of the Hlth Scis, Bethesda, MD, USA, 2 Madigan Army Med Cntr, Takoma, WA, USA, 3 San Antonio Military Med Cntr, Fort Sam Houston, TX, USA, 4 NIAID, Bethesda, MD, USA Background: The Veterans Aging Cohort Study (VACS) Index predicts all-cause mortality among HIV infected populations, as well as non-AIDS cardiovascular (CV) and neurocognitive diseases. The US Military HIV Natural History Study (NHS) is a longitudinal cohort of HIV infected military active duty and beneficiaries that collects detailed clinical information including medical diagnoses. We evaluated the VACS Index as a predictor of non-AIDS, as well as AIDS and mortality risk in the NHS. Methods: We included all NHS subjects with HAART initiation (HI) from 1996 to 2014, who had all VACS Index variables, and at least one year of follow-up after HI. We evaluated the correlation of VACS Index with mortality, AIDS, and non-AIDS conditions (including cancer, CV, gastrointestinal, respiratory, endocrine, musculoskeletal, neurological and psychological diseases) individually, by group, and in aggregate. We calculated Harrell’s concordance index at three time points (HI, 6 months after HI, and 1 year after HI). Harrell’s c > 0.5 implies a prediction ability, increasing as the value approaches 1. Levels >0.7 are often considered evidence of good prediction. Results: 2,091 participants (93.3%male, 44.7% African American, median age 32.7 years ([IQR 12.0 years]) met our inclusion criteria. The mean/median VACS Index scores at HI were 22.5/17.0, at 6 months 13.9/10.0 and at 1 year 13.4/10.0 [VACS Index can range from 0 to 164]. The Harrell’s c index between the VACS Index and death or AIDS showed strong correlations at all three time-points (Table). For more severe non-AIDS illnesses such as cancer and CV disease, the correlation was not as strong. Earlier precursors of disease such as hypertension and hyperlipidemia were not correlated with the VACS index. The VACS Index also did not correlate highly with other diseases such as depression or asthma. Conclusion: In this longitudinal cohort of young, healthy individuals, and a substantial number of African Americans, the VACS Index decreased after HAART initiation, as expected, and was strongly correlated with mortality and AIDS. For serious non-AIDS, such as a CV event or cancer, although not strongly correlated, the correlation trended positive; evaluation was limited by the number of endpoints. The VACS Index was not predictive of less serious non-AIDS diseases. In our HIV infected cohort, the VACS Index was a useful predictor of clinical outcomes with graded correlation along the spectrum of HIV related disease.

669 AMERICAN GINSENG FOR THE TREATMENT OF HIV FATIGUE: A RANDOMIZED CLINICAL TRIAL Adriana Andrade 1 , Jeff Sloan 2 , Chun-Su Yuan 3 , Brent Bauer 2 , Paul Novotny 2 , Judith Rabkin 4 , Jeffrey Hsu 1 , Adrian Dobs 1 , Todd Brown 1 1 The Johns Hopkins Univ, Baltimore, MD, USA, 2 Mayo Clinic, Rochester, MN, USA, 3 Univ of Chicago Med, Chicago, IL, USA, 4 Columbia Univ, New York, NY, USA

Background: HIV-related fatigue is prevalent and linked to neurocognitive deficits, nonadherence, poor quality of life (QOL) and physical functioning, but targeted treatment for HIV fatigue is not available. Research suggests American ginseng (AG) may ameliorate cancer fatigue. We examined the safety and efficacy of AG for HIV-related fatigue.

CROI 2017 289