CROI 2017 Abstract e-Book

Abstract eBook

Poster and Themed Discussion Abstracts

889 USE OF TESTING HISTORY TO IDENTIFY HIV-INFECTED PEOPLE AT HIGH RISK OF TRANSMISSION Laurie Linley 1 , Richard M. Selik 1 , Xiaona Qian 2 , Alexandra Oster 1 1 CDC, Atlanta, GA, USA, 2 ICF Intl, Atlanta, GA, USA

Poster and Themed Discussion Abstracts

Background: Acute HIV infection (AHI) is more infectious than later stages of infection, but only a small percentage of HIV infections are recognized as acute at diagnosis. Detecting AHI could provide an opportunity to reduce transmission. Information on the interval between a previous negative HIV test result and the diagnosis of HIV infection could help identify AHI, but laboratory reports of previous negative results are often not available at diagnosis. We compared diagnoses for which lab reports of the last negative test result was available with those for which the last negative test was available only from other sources of testing history (e.g., patient, provider) to assess the usefulness of testing history from lab reports and other sources in identifying AHI. Methods: We analyzed National HIV Surveillance System data for persons aged ≥13 years with HIV diagnosed during 2008-2014 from 21 US jurisdictions that collected data on dates of last negative HIV tests from both lab reports and other sources. We defined AHI as HIV infection in which the reported date of last negative test was < 60 days before diagnosis. We divided AHI cases into those based on lab report and those based on other sources, and compared viral load (VL) and results from incidence assays (BED HIV-1 incidence IA or CDC-modified Bio-Rad HIV-1/HIV-2 plus O avidity IA; a “recent” result indicates duration of infection within 6-8 months post-seroconversion on average). Results: Of 220,195 diagnoses, 6% had a last negative test by lab report, of which 18%were AHI; 23% had a last negative test from other sources, of which 6%were AHI (Table). Among AHI cases with VL data, the percentage with a VL ≥ 100,000 copies/mL was higher for lab report-based AHI (65%) than for other source-based AHI (30%, p<0.001). Among AHI cases with incidence assay results, the percentage with results indicating recent infection was higher for lab report-based AHI (85%) than for other source-based AHI (38%, p<0.001). Conclusion: Persons with AHI based on lab report were more than twice as likely to have a high VL or an incidence test indicating recent infection as those with AHI based on other sources. These findings indicate that data on last negative tests from other sources are not as accurate as those from lab reports for identifying AHI. Improving collection of the last negative HIV test results from laboratory reports could improve the ability of HIV surveillance programs to identify persons with AHI, and thereby to prevent further transmission.

890 VIRAL LOADS NEAR HIV DIAGNOSIS: VARIATION WITH STAGE (0, 1, 2, OR 3) AT DIAGNOSIS Richard M. Selik, Laurie Linley , Mi Chen

CROI 2017 386