CROI 2018 Abstract eBook

Abstract eBook

Poster Abstracts

frequent emergency room visits, and lower CD4 counts, but not with viral suppression. Further studies are needed to better understand who is at risk for depression and how depression affects healthcare utilization and HIV health outcomes.

754 DEPRESSIVE SYMPTOMS AND HIV INFECTION IN AN AGING UGANDAN COHORT Jennifer Manne-Goehler 1 , Bernard Kakuhikire 2 , Alexander C. Tsai 3 , Till Bärnighausen 4 , Samson Okello 2 , Mark J. Siedner 3 1 Beth Israel Deaconess Medical Center, Boston, MA, USA, 2 Mbarara University of Science and Technology, Mbarara, Uganda, 3 Massachusetts General Hospital, Boston, MA, USA, 4 Heidelberg University, Heidelberg, Germany Background: The measured prevalence of major depressive disorder has increased in sub-Saharan Africa in recent years, and depression is a common comorbidity among people living with HIV (PLWH) in the region. However, there are limited data regarding relationships between depression, engagement in HIV care, and use of antiretroviral therapy (ART), especially in low- and middle- income settings. This study aims to characterize associations between HIV infection & depressive symptoms in a cohort of aging PLWH on ART and among sex and age-matched, population-based, HIV-negative comparators. Methods: We used data from the Ugandan Non-Communicable Diseases & Aging Cohort Study (UGANDAC) to estimate the association between HIV infection, ART use, and depressive symptoms. The study included 154 PLWH and 142 community-based, HIV-negative controls. The Hopkins Checklist (HSCL), a 15-item depression scale, was used to screen for probable depression. In a subset of PLWH (n=102), a pre-ART depression score was also available. We estimated differences in depressive symptoms by HIV status, comparing both pre-ART and post-ART depression scores among PLWH with those of the HIV- negative group. We then used multivariable adjusted log binomial regression to estimate the association between HIV infection and probable depression, adjusting for age, sex, education and wealth. Results: PLWH on ART had significantly lower depression symptom scores than controls (median score: 1.38 [IQR 1.20 – 1.67] v. 1.53 [IQR 1.27 – 1.87], p=0.006) and a lower prevalence of probable depression (21.4 v. 33.8%, p=0.017). Among 102 PLWH with pre-ART depression screening scores available, the median depression score prior to ART was not significantly different from the median score in the HIV-negative group (1.38 v. 1.53, p=0.063) (see Figure 1). In multivariable adjusted log binomial regression models, PLWH on ART had a lower prevalence of probable depression than HIV-negative controls [adjusted prevalence ratio: 0.68 (95% CI: 0.47 – 0.99)]. Conclusion: Depressive symptoms were similar among pre-treatment PLWH & HIV-negative comparators. However, after enrollment in ART care, we found significantly lower depression scores and lower odds of probable depression, as compared to age & sex-matched, HIV-negative comparators. These data add to a growing body of literature showing improved physical & mental health indicators among PLWH on ART in sub-Saharan Africa. Further research is needed to elucidate the mechanisms underlying this phenomenon.

755 EFFECTS OF HIV STATUS ON FUNCTIONAL BENEFITS OF EXERCISE IN OLDER SEDENTARY ADULTS Kristine M. Erlandson 1 , Samantha MaWhinney 1 , Melissa P. Wilson 1 , Lilyana Gross 1 , Sean A. McCandless 1 , Wendy M. Kohrt 1 , Robert Schwartz 1 , Todd T. Brown 2 , Thomas Campbell 1 , Catherine M. Jankowski 1 1 University of Colorado Anschutz Medical Campus, Aurora, CO, USA, 2 Johns Hopkins Hospital, Baltimore, MD, USA Background: Whether older, sedentary HIV+ adults can achieve similar functional benefits with exercise as their HIV- peers and the ideal intensity of exercise needed for these benefits is not known. Methods: Older (50-75 years of age) sedentary HIV+ (undetectable HIV-1 RNA on antiretroviral therapy for ≥ 2 years) and HIV- participants were recruited for a 24 wk supervised, 3x/week cardiovascular and resistance exercise program. Participants exercised at moderate intensity for 0-12 wks, then were randomized to moderate (50% V02 maximum [V02max], 60-70% 1-repetition maximum [RM]) or high intensity (70% V02max, ≥80% 1-RM) exercise for an additional 12 wks. 10x chair rise time and 1-RM were measured every 3 wks; V02max and 400-mwalk time at wk 0, 12, and 24. Outcomes by serostatus and exercise intensity were compared using linear and mixed effects regression models and adjusted for baseline values (for wk 0-12) or wk 12 (for 12-24 wk change). Results: 28 HIV+ and 31 HIV- participants completed 12 wks; 27 HIV+ (12 moderate/15 high) and 30 HIV- (14 moderate/16 high) completed 24 wks of exercise. HIV+ participants were thinner (BMI 27 vs 30 kg/m2), younger (57 vs 60 years), less likely never smokers (39 vs 58%), and had more comorbidities (79 vs 55%with ≥3) compared to HIV-. Among HIV+ participants the CD4+ T-cell was 564 (467,682) cells/mm 3 , and mean time since HIV diagnosis was 20 (17,23) yrs. At week 0, HIV+ participants had faster 400-mwalk time but slower 10x chair rise (Table) compared to HIV- participants. Both groups had significant improvements in all physical function measures except V02max from 12-24 wks in HIV+ for moderate intensity (Table). HIV+ participants had significantly greater improvements than HIV- on V02 max between wk 0-12 (5 [0,10]% greater; p=0.04) and in 400-mwalk between weeks 12-24 (-3 [-5,0]% faster; p=0.03). An interaction between exercise intensity and HIV serostatus was significant only on 1-RMmeasures: HIV+/high-intensity exercisers gained significantly more strength than HIV+/moderate exercises in bench press (6 [0, 12]% greater) and leg press (10 [2, 17]% greater; both p<0.05); HIV- had similar gains regardless of intensity. Conclusion: Exercise training reverses physical function impairment to a similar extent in older, sedentary HIV+ and HIV- adults. HIV+ persons randomized to high intensity exercise showed greater gains in strength than HIV- persons, which may suggest an added benefit of high intensity exercise among older sedentary HIV+ adults.

Poster Abstracts

CROI 2018 282