CROI 2020 Abstract eBook

Abstract eBook

Poster Abstracts

Methods: Twenty five HIV/HCV coinfected (HIV/HCV group),25 HIV-infected (HIV group) and 20 healthy controls (HC) were included. All patients were on ART and HIV suppressed. Parameters of systemic inflammation, endothelial activation and coagulation were measured on plasma samples using Human Custom ProcartaPlex kit (Invitrogen,Thermo Fisher Scientific) and acquired on a Luminex analyzer (Bio-Plex 200 System by Biorad). Cross-sectional and longitudinal (comparing baseline vs 12 weeks after end of treatment in HIV/HCV group) analyses were performed. Non-parametric tests were used to establish inter and intra-group differences. Results: No significant differences between HIV and HC groups were observed for any of the parameters analyzed. In contrast, at baseline HCV/ HIV group showed increased levels of IL-18 (p=0.028), IP-10 (p<0.0001), VCAM-1 (p<0.0001) and ICAM-1 (p=0.045) compared to HC and HIV groups. Interestingly, the highest levels of these markers were observed in HCV/HIV patients with significant liver fibrosis (>F2, n=10), with significant differences between F2 HIV/HCV patients for IL18 and IP10 (p=0.007 and p=0.015, respectively). Of note, after HCV eradication, levels of VCAM-1 remained significantly increased compared to HIV and HC groups (p=0.006) with a similar profile in patients with (>F2) and without (

591 COST-SAVING OF POOLED HCV RNA TESTING TO DIAGNOSE ACUTE HCV IN HIGH-RISK POPULATIONS Hsin-Yun Sun 1 , Yi-Ting Chen 1 , Wen-Chun Liu 1 , Li-Hsin Su 1 , Yu-Chung Chuang 1 , Yu-Shan Huang 1 , Un-In Wu 1 , Kuan-Yin Lin 1 , Sui-Yuan Chang 1 , Chien-Ching Hung 1 1 National Taiwan University Hospital, Taipei, Taiwan Background: Acute HCV infection has emerged as a sexually transmitted disease (STD) in MSM. With highly effective direct acting antivirals (DAAs) against HCV, timely diagnosis and treatment of acute HCV infection can curb further transmission. Given the cost concerns about HCV RNA testing, we assessed the cost-saving strategy with the use of pooled sera for HCV RNA testing to diagnose acute HCV infection in high-risk populations. Methods: We enrolled HIV-positive patients without HCV infection who presented with STDs or elevated aminotransferases within 6 months, HIV- positive patients with spontaneous HCV clearance or achievement of sustained virologic response (SVR) with HCV treatment, and PrEP users without HCV infection. A total of 20 specimens were combined into a pooled specimen for HCV RNA testing. STD screening was performed for HIV-positive patients or PrEP users with STDs. All of the 20 patients would be considered free of HCV if a pooled specimen was tested negative for HCV RNA. For any pooled specimen tested positive, every 5 specimens of the 20 specimens would be combined into a sub-pooled specimen for HCV RNA testing. For a sub-pooled specimen tested positive, each of the 5 specimens would be retested individually to identify the one with HCV. Results: From Jun 25 to Sep 19, 2019, 322 individuals were enrolled, including 304 (94.4%) HIV-positive patients and 18 (5.6%) PrEP users, with 99.1% being MSM. Patients were enrolled because of STDs in 228 (75.0%), follow-up of HCV status after SVR in 79 (26.0%) or spontaneous HCV clearance in 9 (3.0%), and elevated aminotransferases in 8 (2.6%). Chlamydia infection was identified in 23.4% (49/209) of HIV-positive patients and 44.4% (4/9) of PrEP users, while gonorrhea was diagnosed in 11.5% (24/209) of HIV-positive patients and 22.2% (2/9) of PrEP users. Acute HCV infection was diagnosed in 8 (2.5%) patients (3 with STD, 2 STD/SVR, 3 elevated aminotransferases) at the first determination and 1 at the second determination 3 months later, with negative anti-HCV antibody in 2. Instead of 340 tests, a total of 89 HCV RNA tests were needed to identify the 9 individuals with acute HCV infection by the pooled-serum approach, and we were able to save 73.8% of the total cost required if all the specimens had been tested individually. Conclusion: Pooled HCV RNA testing is cost-saving to diagnose acute HCV infection in high-risk populations. 592 PERSISTENT HIV CONTROLLERS ARE MORE PREDISPOSED TO SPONTANEOUSLY CLEAR HCV Beatriz Dominguez-Molina 1 , Laura Tarancon-Diez 1 , Yusnelkis Milanes- Guisado 1 , Miguel Genebat 1 , Salvador Resino 2 , Carmen Rodriguez 3 , Norma Rallón 4 , Cecilio Lopez-Galindez 2 , José Miguel Benito 4 , Felipe Garcia 5 , Jorge Romero 3 , Pompeyo Viciana 1 , Luis López-Cortés 1 , Manuel Leal 1 , Ezequiel Ruiz-Mateos 1 1 Institute of Biomedicine of Seville, Sevilla, Spain, 2 Institute de Salud Carlos III, Majadahonda, Spain, 3 Centro Sandoval, Madrid, Spain, 4 Fundacion Jimenez Diaz, Madrid, Spain, 5 Hospital Clinic of Barcelona, Barcelona, Spain Background: HIV-controllers have the ability to spontaneously maintain viremia at low or undetectable levels in absence of antiretroviral treatment. Furthermore, HIV controllers seem to have superior capacity to spontaneously clear hepatitis C virus (HCV) coinfection compared to non HIV-controllers. Some of these subjects eventually lose HIV-controller status (transient controllers), in contrast with HIV-controllers with persistent natural HIV control (persistent

Poster Abstracts

CROI 2020 213