CROI 2018 Abstract eBook

Abstract eBook

Poster Abstracts

Conclusion: Our results do not support the hypothesis that treatment modification improves NC function in patient under stable treatment with EFV.

419 BENEFICIAL EFFECT OF 6 MONTHS OF PROBIOTICS ON ASYMPTOMATIC NEUROCOGNITIVE IMPAIRMENT Luigi Celani , Eugenio Nelson Cavallari, Mariangela Fratino, Claudia Pinacchio, Giuseppe Corano Scheri, Gabriella De Girolamo, Giancarlo Ceccarelli, Claudio M. Mastroianni, Carolina Scagnolari, Vincenzo Vullo, Gabriella d’Ettorre Sapienza University of Rome, Rome, Italy Background: HIV infected subjects show high prevalence of mild neurocognitive symptoms; individuals with Asymptomatic Neurocognitive Impairment (ANI) show increased risk of future symptomatic decline but to date interventional strategies to prevent the onset of symptomatic conditions have not been defined. Methods: 35 HIV infected individuals successfully treated with HAART were enrolled in this unblinded, non-randomized study. At baseline (T0) a battery of 20 neurocognitive tests was administered to evaluate patients’ cognitive function and a lumbar puncture was performed to determine neopterin concentration in cerebrospinal fluid (CSF). Subsequently, 9 participants underwent a 6 months course of antiretroviral therapy supplementation with a commercially available oral probiotic (2 sachets, each containing 450 billion bacteria, twice a day; composition: Lactobacillus plantarum , Streptococcus thermophilus , Bifidobacterium breve , Lactobacillus paracasei , Lactobacillus delbrueckii subsp. bulgaricus , Lactobacillus acidophilus , Bifidobacterium longum , Bifidobacterium infantis ); after supplementation, participants included in the interventional group were evaluated with a second lumbar puncture and with a second neurocognitive tests assay, whereas controls, for ethical reasons, underwent a second battery of neurocognitive tests after 12 months (T12). Results: At T0, demographics, variables related to infection and neurocognitive tests results were similar between the two groups; all participants showed an abnormal result in at least one test exploring the executive functions and most individuals presented a pathological impairment in at least two different domains; neopterin concentration in CSF was elevated in 33 out of 35 patients and an higher neopterin level was correlated with a poorer result in several neurocognitive tests. After supplementation with probiotics (T6), participants in the interventional group presented a significant decrease of neopterin concentration (p <0.005) and a significant improvement in many neurocognitive tests, while no significant modifications were observed between T0 and T12 in controls (data showed in Table 1). Conclusion: Supplementation with this specific probiotic could represent a useful strategy to ameliorate cognitive function in HIV infected individuals with ANI. Further investigations are needed to define the long term benefits of supplementation with this product.

Poster Abstracts

420 LOW DOSE HYDROCORTISONE ENCHANCES COGNITIVE FUNCTIONING IN HIV-INFECTED WOMEN

Leah H. Rubin , Luan Phan, Pauline M. Maki University of Illinois at Chicago, Chicago, IL, USA

Background: Low dose hydrocortisone (LDH) administration enhances aspects of learning and memory in some populations including PTSD. HIV-infected men demonstrate only acute enhancing effects of LDH on verbal learning; however, the cognitive effects of LDH in HIV-infected women remain unknown. Understanding these effects in HIV-infected women are particularly important given findings from large-scale studies showing stress-related learning and memory impairment in the context of HIV. Methods: In a double-blind, placebo-controlled, cross-over study we examined the time-dependent effects of a single low dose administration of hydrocortisone (10mg oral; LDH) on cognition in 36 HIV-infected women. Participants were randomized to LDH or placebo and the opposite treatment was given one month later. After pill administration, cognition was assessed 30- minutes (assessing nongenomic effects) and 4-hours later (assessing genomic effects). Self-reported stress/anxiety and salivary cortisol were assessed throughout sessions. Results: LDH significantly increased salivary cortisol levels versus placebo; levels returned to baseline 4-hours post-administration. At the 30-minute assessment, LDH enhanced verbal learning and memory, working memory, behavioral inhibition, and visuospatial abilities. At the 4-hour assessment, LDH enhanced verbal learning and memory compared to placebo. LDH did not affect subjective stress/anxiety or any other cognitive domain at either time point. Conclusion: The enduring effects of LDH on learning and memory suggest potential clinical utility in HIV-infected women. These findings are in contrast to our findings in HIV-infected men who did not show any cognitive benefits at the 4-hour time point. Larger, longer-term studies are under way to verify possible sex-specific cognitive enhancing effects of LDH and the clinical significance of these effects in HIV.

CROI 2018 148