CROI 2020 Abstract eBook

Abstract eBook

Poster Abstracts

629 BREAST CANCER RISK IN WOMEN LIVING WITH HIV IN SOUTH AFRICA: THE SAM STUDY Maša Davidović 1 , Tafadzwa G.Dhokotera 1 , Lina Bartels 1 , Katayoun Taghavi 1 , Frédérique Chammartin 1 , Victor Olago 2 , Elvira Singh 2 , Matthias Egger 1 , Mazvita Sengayi 2 , Julia Bohlius 1 1 University of Bern, Bern, Switzerland, 2 National Health Laboratory Service, Johannesburg, South Africa Background: In the Republic of South Africa (RSA), approximately 17% of women were living with HIV (WLHIV) in 2017. Greater access to antiretroviral therapy (ART) has increased the survival of WLHIV in recent years and moved the distribution of cancer diagnoses toward non-AIDS-defining cancers, including breast cancer (BC). According to National Cancer Register South Africa (NCR SA) Report, in 2014 BC was the most commonly diagnosed cancer in women in RSA, with an age-standardized incidence rate of 33.3 per 100 000 population. However, in WLHIV, the incidence and risk factors for BC are not well understood. Methods: The South African HIV Cancer Match (SAM) study used privacy preserving record linkage to create a large cohort of cancer in people living with HIV from national laboratory and cancer registry data. We included WLHIV aged 16 years and older with confirmed HIV status by two or more HIV related tests and with cancer diagnosed between 2004 and 2014 in the SA public health sector laboratories. We calculated BC incidence per 100 000 person-years, based on the number of WLHIV with histology-confirmed BC. We derived Cox regression model stratified by province of first HIV test to obtain hazard ratios of associations with first reported CD4 cell count, age, sex and calendar period. Results: Between 2004 and 2014, over 8 586 130 person-years of follow-up, 4 083 incident BC cases were diagnosed in the SAM cohort of 3 137 992 WLHIV. BC incidence rate was 47.6 cases per 100 000 person-years (95% CI 46.1-49.0). The median age of WLHIV at baseline was 32 years (interquartile range (IQR): 26-40), and the median age at diagnosis was 44.9 years (IQR: 38-52.1). The median baseline CD4 cell count was 310 cells/μL (IQR: 177-477). There was general increase in CD4 cell count through calendar years. Only age was strongly associated with BC risk (Table 1). Conclusion: We found no evidence of association between immunosuppression and BC risk in WLHIV in RSA. BC incidence in WLHIV was high and increased with age, closely similar to what is observed in the NCR SA data for the general female population. Additional analyses of trends in the stage at BC diagnosis and BC mortality are needed to inform the public health response to BC in WLHIV in RSA.

incidence assessment of lymphoma, cases occurring within 30 days after cohort enrollment were excluded. Results: During the study period, 3,484 patients received HIV care for a total of 22,903 person-years (py). HMs were identified in 43 patients (Figure 1) (31 males, 12 females). The incidence rate of lymphoma was 127,6/100 000 py, compared to 21,2/100 000 py in the general population in Sweden (Socialstyrelsen). In the early period, 2004–2010, the incidence rate was significantly higher compared to the late period, 2011–2018 (232,4 vs 73,4 per 100 000 py; p=0.003). Median follow up time was 7,6 years (IQR 3,1–9,3). Median time from HIV diagnosis was significantly shorter in patients developing NHL compared to HL (1,2 vs 8,9 years; p=0.01). Fourteen patients with HMs (33%) were diagnosed within 6 months of HIV diagnosis. Treatment with effective ART (>180 d prior to malignancy) with undetectable viral load was significantly more common in the HL group compared to NHL (89% vs 30%; p=0.005). Median CD4+ cell count at malignancy diagnosis was 190 cells/ml and a majority (86%) had a nadir CD4+ cell count <200 cell/ml. A majority of the patients (79%) received chemotherapy. Autologous hematopoietic stem-cell transplantation was conducted in three cases. Eighteen deaths occurred during the study period with a median time frommalignancy to death of 0,4 years (IQR 0-1,4). The five-year survival rate for lymphoma was 55% (16/29), as compared to 74% (p=0,03) five-year survival rate for lymphoma in the general population in Sweden (Socialstyrelsen). Conclusion: The incidence rate of lymphoma was more than 6 times higher in PLHIV and the five-year survival rate was significantly poorer when compared to general population in Sweden. The incidence declined in recent years. HL occured significantly later and were more frequent in PLHIV on effective ART.

Poster Abstracts

631 IMMUNO-VIROLOGICAL PARAMETERS IN PEOPLE LIVING WITH HIV UPON ANTI-PD-1/L-1 FOR CANCER Jean-Philippe Spano 1 , Joséphine Anna Tine 2 , Amélie Guihot 1 , Cathia Soulie 2 , Anne-Geneviève Marcelin 1 , Marianne Veyri 1 , Marine Baron 1 , Séverine Gibowski 2 , Armelle Lavolé 3 , Alain Makinson 4 , Isabelle Poizot-Martin 5 , Christine Katlama 1 , Dominique Costagliola 2 , Lambert Assoumou 2 , Olivier Lambotte 3 1 AP–HP, Hôpitaux Universitaires Pitié Salpêtrière, Paris, France, 2 INSERM, Paris, France, 3 AP–HP, Paris, France, 4 CHU de Montpellier, Montpellier, France, 5 Assistance Publique–Hopitaux Marseille, Marseille, France Background: To characterize tolerance, immuno-virological parameters and efficacy data in people living with HIV (PLHIV) receiving Immune-CheckPoint Inhibitors (ICPi) (anti-PD1 or anti PDL1), a cohort was set up. Methods: The ANRS CO24 ONCOVIHAC (NCT03354936) is an ongoing prospective cohort study in France enrolling PLHIV with cancer treated by ICPi. HIV RNA viral load (VL), CD4 and CD8 were collected at baseline (date of first ICPi injection) and during follow-up, as were adverse events (AEs). Results: From January 17th, 2018 to September 21st, 2019, 43 patients were enrolled across 20 sites. Among them, 31 enrolled at least 6 months ago were included in this analysis. Median age was 59 years (IQR: 53-66) and 25 (80.6%) were males. HIV has been diagnosed in 1990 (1987–1997) and CD4 nadir was 98/ µL (42–240) with 22.6% prior AIDS events. At baseline, 20 received nivolumab, 10 pembrolizumab and 1 atezolizumab for the following cancers: lung (n=15), melanoma (4), head/neck (4), bladder (3), Hodgkin (3), Kaposi sarcoma (1), anal (1), tongue (1), squamous cell carcinoma (1). All patients were under cART with a median CD4 count of 314/µL (148–642) and CD4/CD8 ratio of 0.46 (0.37–0.94) and 5 had HIV RNA >50 copies/mL with a median of 4.6 log 10 (4.3–5.1). During a mean follow-up of 8.1 months (21.0 person-years), 101 AEs occurred in 25 pts with 28 grade 3/4 AEs in 15 pts and only 2 Immune-mediated AEs in 2 pts

630 HIV-ASSOCIATED HEMATOLOGIC MALIGNANCIES IN PEOPLE LIVING WITH HIV IN SWEDEN Oscar Kieri 1 , Piotr Nowak 1 , Anders Sönnerborg 1 , Gaetano Marrone 1 1 Karolinska Institute, Stockholm, Sweden Background: People living with HIV (PLHIV) have an increased risk of developing hematologic malignancies (HM) and in particularly non-Hodgkin lymphoma (NHL) and Hodgkin lymphoma (HL). Despite a decline observed since the introduction of effective combined antiretroviral therapy (ART) the risk is still increased. There is no published data regarding HMs in PLHIV in the era of ART in Sweden. Methods: A retrospective study was conducted of PLHIV receiving care at the Department of Infectious Diseases, Karolinska University Hospital, between 01/2004 and 12/2018. PLHIV diagnosed with HMs were identified and data was collected linking the InfCareHIV cohort with medical records. For

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