CROI 2018 Abstract eBook

Abstract eBook

Poster Abstracts

including protease inhibitor (p: 0.1). 22 pts in the Fenofibrate group and 23 in the O3 group completed follow up at week 96. Changes from baseline to week 96 in bone mineral density (BMD), bone turnover markers and TG are presented in table 1. Conclusion: Twenty four month Omega-3 fatty acid supplementation resulted in no beneficial changes in BMD and bone turnover markers. Moreover, we observed a marked reduction in BMD in proximal femur in both groups, mainly in the O3 group associated with a significant decrease in 1,25-(OH)2D3. Larger studies are required to confirm these findings and investigate their clinical significance.

10% increase;95%CI: 0.57,0.99), while in HIV+ women, higher CD4 count was associated with non-significantly higher odds of hyperkyphosis (OR 2.47 per doubling;95%CI: 0.88,6.90). Conclusion: In our study of early-postmenopausal women, contrary to our hypothesis, we did not find that HIV+ women had greater hyperkyphosis than HIV- women. As expected, lower lumbar spine BMD was associated with hyperkyphosis. Further study is needed in a larger cohort of aging post- menopausal women with HIV. 728 PEOPLE LIVING WITH HIV IN FRANCE HAVE DELAYED ACCESS TO KIDNEY TRANSPLANTATION Jérome Tourret 1 , Sophie Abgrall 1 , Mathilde Lassalle 1 , Sophie Grabar 1 , Corinne Isnard-Bagnis 1 , Gilbert Deray 1 , Benoit Barrou 1 , Dominique Costagliola 2 , Cecile Couchoud 1 , Marguerite Guiguet 2 , Sophie Tezenas du Moncel 1 1 AP–HP, Paris, France, 2 INSERM, Paris, France Background: Kidney transplantation (KT) is the best renal replacement therapy (RRT) for people living with HIV (PLWH) with end-stage renal disease (ESRD). We analyzed the access to KT waiting list (WL) and to KT after enrolment on WL of PLWH and compared themwith those of uninfected patients. Methods: Using REIN, the national end stage renal disease registry, we included all adult PLWH who initiated RRT in France between 2006 and 2010 and selected up to 2 HIV seronegative controls matched on age, sex, year of RRT initiation, existence of a diabetic nephropathy. Patients were prospectively followed until 12/31/2015. HIV-related data were extracted from the French Hospital Database on HIV (FHDH ANRS CO4). A competing-risk approach was used to assess the cumulative incidence of enrollment on a WL and of KT while listed with death as competing event. Adjusted sub-distribution hazard ratios (AsdHR) are given with 95% confidence intervals. Results: 255 PLWH and 476 matched controls were included: median age 47yrs, 69%males, median follow-up 5.6 and 6.3 yrs since RRT initiation, respectively. PLWH were more often infected with HCV and presented more comorbidities. Two years after RRT initiation, the cumulative probability of enrollment on a KT WL was 46% for PLWH and 64% for controls, and the cumulative probability of death without enrollment was 14% for PLWH and 8% for controls (figure). WL enrollment was delayed for PLWH compared to controls despite an improvement over time (for pts initiating RRT in 2006-2008 : AsdHR 0.43 [0.33 to 0.56] and for those initiating in2009-2010 : AsdHR=0.66 [0.47 to 0.93]; p=0.04 for the test of interaction). After adjustment for blood group and the rate of incompatible transplant, KT was also delayed and less frequent for PLWH (AsdHR=0.68 [0.53 to 0.89]). Access to KT was not different between the periods of RRT initiation (p=0.37 for the test the interaction test). Transient inactivity on the WL was more frequent for PLWH (79%) than for controls (50%; p<0.0001). HIV infection data were available for 180 (71%) of the PLWH of whom 98% received ART. Results were similar when analyses were restricted to PLWH either on ART and having immunologic and virologic response (CD4>200/ mm 3 and VL<500 copies/ml). Conclusion: Despite a slight amelioration with time, PLWH access to WL and KT remains arduous and delayed compared to HIV seronegative controls of the same age.

Poster Abstracts

727 HYPERKYPHOSIS AND AGING IN THE WOMEN’S INTERAGENCY HIV STUDY Anne M. Ritchie 1 , Wendy B. Katzman 1 , Yifei Ma 1 , Rebecca Scherzer 1 , Mardge H. Cohen 2 , Michael T. Yin 3 , Phyllis Tien 1 1 University of California San Francisco, San Francisco, CA, USA, 2 Cook County Health & Hospitals System, Chicago, IL, USA, 3 Columbia University Medical Center, New York, NY, USA Background: HIV+ women have lower bone mineral density (BMD) and a higher rate of fracture than HIV- women, but the contribution of HIV infection to hyperkyphosis is not known. Hyperkyphosis is a geriatric syndrome of multifactorial etiology including decreased BMD, vertebral fracture, and muscle weakness, and is associated with decreased physical function and increased all-cause mortality. We examined whether HIV infection is associated with hyperkyphosis. Methods: Cobb Angle, a radiographic measure of thoracic kyphosis was determined using dual energy Vertebral Fracture Assessment software in a cross-sectional sample of 130 HIV+ and 70 HIV- early post-menopausal women enrolled in the Musculoskeletal Substudy of the Women’s Interagency HIV Study. We performed logistic regression to estimate odds of hyperkyphosis (defined as Cobb Angle≥40°) associated with HIV infection, and to identify factors associated with hyperkyphosis. Candidate covariates included demographic, lifestyle, body composition, and HIV-related factors. Results: Over half of women were African-American; majority was overweight or obese [median BMI:29kg/m2 (interquartile range[IQR]:25,34) in HIV+;30kg/ m2(IQR:27,34) in HIV-] and median age was 50(IQR:48,54) in HIV+ and 49 years (IQR:44,53) in HIV-. HIV+ women had lower lumbar spine(LS), femoral neck(FN), and total hip(TH) BMD than HIV- women [1.19(IQR:1.08,1.31) vs 1.30(IQR:1.1 5,1.41);0.97(IQR:0.89,1.09) vs 1.03(IQR:0.93,1.11)]; and 1.02(IQR:0.91,1.11) vs 1.07(IQR:0.98,1.17), respectively]. There was little difference in median Cobb angle [29°(IQR:23°,35°) in HIV+ vs. 30°(IQR: 23°,36°) in HIV-;p=0.86]; 10% of each group had hyperkyphosis. In age-adjusted analysis, HIV infection was not associated with hyperkyphosis (Odds Ratio [OR]:0.94;95% Confidence Interval [CI]:0.35,2.5) when compared to those without HIV infection. Factors associated with hyperkyphosis in age-adjusted analyses included LS BMD and CD4 count. Greater LS BMD was associated with lower odds of hyperkyphosis (OR:0.75 per

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