CROI 2017 Abstract e-Book

Abstract eBook

Poster and Themed Discussion Abstracts

672 BIOMARKERS OF AGING IN HIV-POSITIVE INDIVIDUALS AND MATCHED CONTROLS Davide De Francesco 1 , Sebastian Oehlke 2 , Alexander Bürkle 2 , Ferdinand Wit 3 , Claudio Franceschi 4 , Neeltje A. Kootstra 5 , Claude Libert 6 , Peter Reiss 3 , Caroline Sabin 1 , for the Co- morBidity in Relation to Aids (COBRA) Collaboration 1 Univ Coll London, London, UK, 2 Univ of Konstanz, Konstanz, Germany, 3 Stichting HIV Monitoring and Academic Med Cntr, Amsterdam, Netherlands, 4 Alma Mater Studiorum Univ di Bologna, Bologna, Italy, 5 Academic Med Cntr, Amsterdam, Netherlands, 6 VIB, Ghent, Belgium Background: Despite successful combination antiretroviral therapy (cART), HIV+ve people have been suggested to experience signs of more rapid aging. We compared established aging biomarkers in HIV+ve people aged ≥45 years and demographically-comparable HIV-ve controls and identified factors associated with apparent age advancement in both groups. Methods: The biological age of each individual was derived using a set of 10 biomarkers (5 of which were measured in mononuclear cells), identified through the EU FP7 MARK-AGE project. The difference between biological and chronological age (‘age advancement’) was assessed for significance in each group using paired t-tests, with associations between this age advancement and HIV status, lifestyle, viral (cytomegalovirus (CMV), hepatitis B (HBV) and C (HCV) viruses) and HIV parameters investigated using t-tests, Pearson’s correlation coefficient and linear regression. Results: Biomarkers were measured in 134 HIV+ve (median age: 56 yrs (range 45-82), 93%male, 88%white ethnicity, 86%MSM) and 79 HIV-ve (median age: 57 yrs (range 46-80), 92%male, 97%white ethnicity, 80%MSM) people. Biological age was significantly greater than chronological age by 13.2 and 5.5 yrs in the HIV+ve and HIV-ve groups, respectively (p<0.0001 for each, Table 1), with the apparent age advancement being significantly greater in HIV+ve than HIV-ve persons (p<0.0001). No significant associations were found between age advancement and lifestyle factors, but higher total and high avidity anti-CMV IgG antibody titer were both associated with an increased age advancement, independently of HIV-status (p=0.03 and p=0.02, respectively). In HIV+ve persons, a positive correlation was found between age advancement and time since HIV diagnosis (r=0.17, p=0.05), duration of cART (r=0.17, p=0.05) and time with a CD4 count <200 cells/µL (r=0.19, p=0.03). HIV+ve persons co-infected with HBV also showed a greater age advancement. Conclusion: Our findings suggest that there is an apparent advancement in biological age in successfully treated HIV+ve people. Whilst this does not appear to be explained by differences in participant characteristics, and may reflect the effects of HIV on monocytes and lymphocytes, we cannot rule out the possibility that other unmeasured confounders may exist. Longitudinal follow-up will allow us to further investigate the causal nature of the association and whether it is likely to reflect a process of accentuated or accelerated aging.

Poster and Themed Discussion Abstracts

673 LONGITUDINAL ASSOCIATION BETWEEN ALCOHOL USE AND INFLAMMATORY BIOMARKERS

Kaku So-Armah 1 , Matthew Freiberg 2 , Debbie Cheng 1 , Gregory Patts 1 , Russell Tracy 3 , Margaret Doyle 3 , Natalia Gnatienko 4 , Kendall J. Bryant 5 , Evgeny Krupitsky 6 , Jeffrey H. Samet 1 1 Boston Univ, Boston, MA, USA, 2 Vanderbilt Univ, Nashville, TN, USA, 3 Univ of Vermont, Colchester, VT, USA, 4 Boston Med Cntr, Boston, MA, USA, 5 Natl Inst on Alcohol Abuse and Alcoholism, Bethesda, MD, USA, 6 St.Petersburg Pavlov State Med Univ, St. Petersburg, Russian Federation Background: Biomarkers of inflammation (interleukin-6; IL-6), monocyte activation (soluble CD14; sCD14) and altered coagulation (D-dimer) predict mortality. Prior studies on the association of heavy drinking and these biomarkers in HIV populations report mixed results. Limitations of prior work include cross-sectional design and possible misclassification of alcohol use by relying solely on self-reported alcohol consumption. The objectives of the Russia Alcohol Research Collaboration on HIV/AIDS (ARCH) study were to evaluate 1) the association between heavy alcohol use (corroborated by phosphatidylethanol [PEth], an alcohol biomarker) and inflammatory biomarkers over time, and 2) the association between changes in alcohol use and changes in these biomarkers. Methods: This study included 350 HIV-infected (HIV+) antiretroviral therapy naive Russians assessed at baseline, 12 and 24 months. Heavy drinking was defined as >14 drinks/ week or 4 drinks/day (men), and >7 drinks/week or >3 drinks/day (women) by self-report (Timeline Followback) or PEth≥80 ng/mL. Linear mixed effects models were used to determine whether heavy drinking was longitudinally associated with IL-6, sCD14 and D-dimer adjusting for demographics, HIV factors, comorbid conditions, and zinc supplementation (Russia ARCH includes participants in a clinical trial administering zinc). Secondary analyses investigated the association between self-reported changes in average drinks/week and changes in IL-6, sCD14 and D-dimer over the past year. Results: Baseline characteristics: male (71%), mean age 34 years, hepatitis C (87%), smoking (86%) and HIV viremia (mean (SD) log10(HIV RNA)=4(1) copies/mL). Self-reported inflammatory diseases of aging like diabetes (1%) were uncommon. Heavy drinking was common (77%) and associated with elevated IL-6, sCD14 and D-dimer in adjusted models over time (Table). Changes in drinks/week (categorized as: large or small decrease; or large or small increase) after 1 year were not significantly associated with changes in IL-6, sCD14 or D-dimer compared to those with no changes in drinks/week.

CROI 2017 291