CROI 2017 Abstract e-Book

Abstract eBook

Poster and Themed Discussion Abstracts

Poster and Themed Discussion Abstracts

689 PLANNED PRACTICE OF HIV POSITIVE-TO-POSITIVE TRANSPLANTS IN US TRANSPLANT CENTERS Sarah Rasmussen , Mary Grace Bowring, Ashton Shaffer, Allan Massie, Aaron Tobian, Dorry Segev, Christine Durand The Johns Hopkins Univ, Baltimore, MD, USA

Background: End-stage organ disease is increasing among HIV-positive (HIV+) individuals. Solid organ transplant outcomes among HIV+ recipients are excellent but there is a severe organ shortage. The HIV Organ Policy Equity (HOPE) Act of 2013 lifted the federal ban on using HIV+ organs for HIV+ recipients and allows HIV+-to-HIV+ transplants under research protocols. HIV+ organs are a novel source of organs for HIV+ recipients, but their use depends on transplant centers’ knowledge, opinions and practice of these transplants, which is unknown. Methods: From 01/2016-06/2016, we 209 identified US transplant centers that performed ≥1 adult organ transplant between 1/2014-6/2014. A transplant teammember who could represent the center’s practice of HIV+ transplantation was asked to respond. Contact information for 5 centers was unavailable. Relationships between responses and center characteristics from the Scientific Registry of Transplant Recipients were explored using Wilcoxon-Mann-Whitney tests. Results: Overall response rate was 55.9% (114/204). Respondents were transplant surgeons (57.1%), infectious disease physicians (15.2%), hepatologists (7.6%), nephrologists (6.7%), pharmacists (6.7%) and other (6.7%). Nine centers (8.7%) thought HIV+-to-HIV+ transplants were still banned and 22 (21.4%) were unaware they are restricted to research. 50 (55.6%) centers plan to perform HIV+-to-HIV+ deceased donor transplants, 32 (64%) of which had read the research criteria. Sixty-six (72.5%) respondents believed donor to recipient HIV-superinfection is a moderate but manageable risk. Most respondents perceived risks of rejection (70.3%), and infections and hospitalizations (71.4%) as comparable to HIV negative-to-positive transplants but rated the risk of post-transplant HIV-associated nephropathy as unknown (30.8%) or higher (21.9%). Centers planning HIV+-to-HIV+ transplants had higher median transplant volume, HIV+ recipient volume, local HIV prevalence, and use of infectious-risk donor organs (Table 1). Seventy-nine (83.2%) respondents supported HIV+-to-HIV+ living donation. Conclusion: Many transplant centers support and plan to perform HIV+-to-HIV+ transplants. Some centers are still unaware that HIV+-to-HIV+ transplantation is legal or restricted to research. There is substantial support for HIV+ living donor transplantation. Transplant center education is needed to implement HIV+-to-HIV+ transplantation which could alleviate the organ shortage and improve access to transplant among HIV+ and HIV- patients.

690 FOOD INSECURITY IS ASSOCIATED WITH POOR DIABETES CONTROL IN THE WIHS Kartika Palar 1 , Edward A. Frongillo 2 , Tracey Wilson 3 , Mardge Cohen 4 , Eryka Wentz 5 , Adaora Adimora 6 , Daniel Merenstein 7 , Janet M. Turan 8 , Phyllis Tien 1 , Sheri Weiser 1

CROI 2017 301