CROI 2018 Abstract eBook

Abstract eBook

Poster Abstracts

Results: Compared to the HIV-uninfected group, PLWH had higher levels of sCD14 (p=.03), MCP-1 (p<.001), and TNF-α (p=.001) and reported poorer physical health (p<.001). Presence of HIV (p<.001) and older age decade (p<.001) were associated with poorer fine motor skills (i.e., lower scaled scores) (Model F=14.2, p<.001; figure). Among the biomarkers, only D-dimer (ρ=-.17, p=.01) and MCP-1 (ρ=-.24, p=.001) were associated with physical health. D-dimer (r=-.19, p=.01), IL-6 (r=-.15, p=.04), MCP-1 (r=-.16, p=.02), and TNF-α (r=-.17, p=.01) had linear associations with fine motor skills, while sCD14 showed a quadratic association (p=.008), such that lower and higher values of sCD14 were associated with worse fine motor skills. Only d-dimer remained as a statistically significant predictor (p=.02) of fine motor skills in a multivariable model controlling for covariates. Conclusion: Inflammatory processes may contribute to worse physical health, including worse fine motor skills throughout the course of HIV disease. Although neurologic findings (e.g., deficits in motor speed/dexterity) commonly associated with HIV infection have been suggested to largely remit with ART, our analysis indicates continued and worsening fine motor skills across the adult age continuum of PLWH beyond that expected from normal aging alone.

smoking. In a multivariable model, older age (adjusted odds ratio [aOR] 1.68 per 10 years, p=0.05) and diabetes mellitus (aOR 2.81, p=0.04) were associated with higher odds of NCI for women, while higher HDL (aOR 0.78 per 10 mg/dL, p=0.05), higher BMI (aOR 0.93 per 1 kg/m2, p=0.01) and longer duration of ART (aOR 0.89 per year, p=0.04) were protective. Among men, older age (aOR 1.21 per 10 years of age, p=0.10), hepatitis C infection (aOR 1.50, p=0.09), nadir CD4 count (aOR 1.05 per 50 cells/mm 3 , p=0.08), and anti-depressant use (aOR 1.60, p=0.02) were risk factors for NCI, although only anti-depressant use reached statistical significance. Conclusion: Several traditional CV risk factors were associated with NCI in older women living with HIV, whereas similar relationships were not found in men. These data suggest that interventions to prevent NCI in PLWH may differ between women and men.

Poster Abstracts

412 CARDIOVASCULAR RISK FACTORS ASSOCIATED WITH NEUROCOGNITIVE IMPAIRMENT DIFFER BY SEX Felicia C. Chow 1 , Kunling Wu 2 , Katherine Tassiopoulos 2 , Baiba Berzins 3 , Kevin Robertson 4 , Babafemi Taiwo 3 1 University of California San Francisco, San Francisco, CA, USA, 2 Harvard University, Cambridge, MA, USA, 3 Northwestern University, Chicago, IL, USA, 4 University of North Carolina Chapel Hill, Chapel Hill, NC, USA Background: Cardiovascular (CV) disease has been consistently linked with neurocognitive impairment (NCI) in persons living with HIV (PLWH). Despite recognized differences in CV risk profiles between women and men, most studies investigating the association between CV risk and NCI in PLWH have not stratified by sex or have been in men-only cohorts. We investigated sex differences in CV risk factors associated with NCI at entry into a prospective cohort of older PLWH who initiated antiretroviral therapy (ART) in a randomized trial and were followed longitudinally in the AIDS Clinical Trials Group (ACTG) A5322 study. Methods: Participants who underwent a neurocognitive screen (Trailmaking A and B, Hopkins Verbal Learning Test-Revised, Digit Symbol) at A5322 entry were eligible. NCI was defined as ≥1 standard deviations (SD) below the mean on ≥2 tests or ≥2 SD below the mean on ≥1 test. We used separate logistic regression models for women and men to investigate differences in factors associated with CV and NCI. Results: Of 988 participants, 20% (n=195) were women. Mean age was similar between women and men (51 versus 52 years). Fifty-two percent of women were black and 22%white, while 56% of men were white and 25% black. Women had fewer median years of education than men (12 versus 14 years). Women had significantly higher total and high-density lipoprotein (HDL) cholesterol and body mass index (BMI) compared with men, and a trend toward a higher prevalence of diabetes mellitus, anti-hypertensive use, and current

413 IMPACT OF DETERMINANTS OF INCREASED VASCULAR RISK ON NEUROCOGNITION IN HIV+ PATIENTS

Ilaria Mastrorosa , Patrizia Lorenzini, Carmela Pinnetti, Alessandra Vergori, Gabriele Fabbri, Raffaella Libertone, Maria Maddalena Plazzi, Pietro Balestra, Martina Ricottini, Rita Bellagamba, Mauro Zaccarelli, Adriana Ammassari, Stefania Cicalini, Andrea Antinori Lazzaro Spallanzani National Institute for Infectious Diseases, Rome, Italy Background: HIV associated neurocognitive disorder (HAND) remains prevalent also with effective antiretroviral therapy (ART). Chronic inflammation, due either to HIV per se, vascular and metabolic comorbidities, or viral co-infections, has been hypothesized to affect neurocognition. Thus, we investigated the association of determinants of increased vascular risk factors (VasR) with cognitive performances in a large cohort of HIV infected (HIV+) patients (pts). Methods: This was a cross-sectional analysis of all neuropsychological (NP) evaluations performed by HIV+ pts between 2000 and 2017. HAND was assessed through a comprehensive battery of 14 tests on 5 different domains and classified according to Frascati’s criteria. Diabetes (DB), dyslipidemia (DL) and hypertension (HT) were determined by i) patient self-report, ii) co-medications, iii) for DB, fasting glucose > 125 mg/dl, iv) for DL, at least two among: fasting total cholesterol >200 mg/dl, LDL >100 mg/dl, HDL <40 mg/dl for females or <50 mg/dl for males, triglycerides >150 mg/dl for. Body Mass Index (BMI) was calculated. Multivariable logistic model was built to assess link between VasR and HAND after adjustment by all main confounding covariates. Results: We included 3,433 evaluations from 2,031 pts: male 79%, median age 48 years (IQR 40-55), median education 13 years (IQR 8-13), IDUs 20%, median CD4+ nadir 205/mm 3 (IQR 90-325) and current 515/mm 3 (IQR 305-725), HIV-RNA <50 cp/ml 63%, on ART 87%, HCV co-infection (HCV+) 19.5%. Prevalence of

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