CROI 2020 Abstract eBook

Abstract eBook

Poster Abstracts

661 VENTRICULAR ARRHYTHMIA PREVALENCE AND FREQUENCY: THE MULTICENTER AIDS COHORT STUDY Matthew J. Feinstein 1 , Alexander Meyer 2 , Frank J. Palella 1 , Hiroshi Ashikaga 3 , Sabina A.Haberlen 3 , Jared Magnani 4 , Matthew Budoff 5 , Kathryn Berlacher 4 , Sean Altekruse 6 , Gypsyamber D'Souza 3 , Todd T.Brown 3 , Katherine Wu 3 , Wendy Post 3 1 Northwestern University, Chicago, IL, USA, 2 The Ohio State University, Columbus, OH, USA, 3 Johns Hopkins University, Baltimore, MD, USA, 4 University of Pittsburgh, Pittsburgh, PA, USA, 5 University of California Los Angeles, Los Angeles, CA, USA, 6 National Heart, Lung, and Blood Institute, Bethesda, MD, USA Background: People with HIV (PWH) have higher risks for myocardial scar, heart failure, and sudden cardiac death compared with HIV-uninfected (HIV-) persons. However, little is known regarding the relative burden and characteristics of ventricular ectopy and ventricular tachycardia (VE/VT) among PWH. Methods: We evaluated ventricular arrhythmias among men with HIV (MWH) and HIV- men in the Multicenter AIDS Cohort Study (MACS). We included 666 MWH (mean age 54.4 ± 11.1 years, 51.3%white, 31.1% black, 46.2% current smokers, 15.6% diabetic, last CD4 count mean 720 ± 308, and 80.7%with last HIV RNA (viral load) undetectable) and 586 HIV- men (mean age 60.5 ± 11.7 years, 72.3%white, 19.2% black, 54.4% current smokers, 14.3% diabetic) who underwent continuous ambulatory electrocardiographic monitoring (Ziopatch® by iRhythm) for a median of 12.7 days (interquartile range 5.7-13.8 days). The primary endpoint was the occurrence of any VE/VT, comparing PWH vs. HIV-. The secondary endpoint was the total number of ventricular ectopic beats per 24 hours. Additional analyses of primary and secondary endpoints were performed among PWH by CD4 count and viral load. Results: One participant had sustained VT and 43 participants had VT lasting ≥10 (19/666 MWH and 24/586 HIV- men, p=0.22). Any VT/VE was present among 336 PWH (50.4%) and 325 HIV- men (55.9%). Figure 1 displays the distribution of ventricular ectopic beats per 24 hours (log-transformed), by HIV serostatus, and the duration of VT episodes among all participants with any episodes lasting ≥4 beats. After adjustment for age, sex, race, MACS center, smoking, illicit drug use, body-mass index, hypertension, and diabetes, the odds for any VE/VT was similar among PWH vs. HIV- (aOR=1.17 95%CI=0.82-1.68; p=0.39). HIV serostatus with similarly not associated with number of ventricular beats per 24 hours (aOR=123 more beats/24 hours for MWH, 95%CI=-107-354, p=0.29). Among PWH, there was a borderline significant association of lower CD4 count with ventricular beats (per 100 cells/mm 3 lower CD4 count: 86 beats more per 24 hours; 95% CI=-181-8; p=0.07); HIV RNA level was not associated with ventricular beats (p=0.69). Conclusion: We observed no significant difference in the presence or frequency of VT/VE by HIV serostatus among men in the MACS. Among this group of well-controlled PWH, higher CD4 count was associated with marginally less ventricular ectopy at a level not reaching statistical significance.

Poster Abstracts

662 ASSOCIATION BETWEEN HIV AND THE PREVALENCE OF ATRIAL FIBRILLATION AND ATRIAL FLUTTER Ngozi C. Osuji 1 , Sabina A.Haberlen 1 , Hiroshi Ashikaga 2 , Todd T.Brown 2 , Matthew J. Feinstein 3 , Mallory Witt 4 , Lawrence Kingsley 5 , Sean Altekruse 6 , Katherine Wu 2 , Wendy Post 2 1 Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA, 2 Johns Hopkins University School of Medicine, Baltimore, MD, USA, 3 Northwestern University, Chicago, IL, USA, 4 Los Angeles Biomedical Research Institute at Harbor– UCLA Medical Center, Torrance, CA, USA, 5 University of Pittsburgh, Pittsburgh, PA, USA, 6 National Heart, Lung, and Blood Institute, Bethesda, MD, USA Background: People living with HIV are at increased risk for cardiovascular disease (CVD). The association between HIV serostatus and atrial arrhythmias is incompletely understood. This study was conducted to study the relationship between HIV and atrial fibrillation/flutter (AF/AFL). Methods: HIV infected (HIV+) and uninfected (HIV-) participants in the 4-city Multicenter AIDS Cohort (MACS) were assessed for AF/AFL by standard resting 12 lead electrocardiograms (EKG) and/or ambulatory EKG monitoring using Zio patch (iRhythm) in 2016-17. Multivariable logistic regression was used to evaluate the association between the composite outcome of AF/AFL and the primary exposure of HIV infection. Associations were adjusted sequentially, first for demographic variables (age, race and study center), and second for both demographic and CVD risk factors (body mass index, cumulative pack year of smoking, cocaine use since last visit, use of medications to treat hypertension or diabetes, heavy alcohol use (>13 drinks/week), fasting glucose level and systolic BP). Results: The sample included 1669 men; HIV+men were younger than HIV- men (median 55.5 vs 61.7 years, p<0.001) and were more likely to be African-American (30.6% vs 17.9%, p<0.001). Most HIV+men (80.0%) had undetectable viral load (<20 copies/mL). Zio patch was worn for a median of 13.0 days (IQR 5.9,14.0). AF/AFL was present in 12 (1.3%) HIV+men and 25 (3.2%) HIV- men. There was only 1 case of AF/AFL in African-Americans, and 36 cases in Caucasians (2.7% vs 97.3% p<0.001). Although there was a lower odds of AF/AFL among HIV+ compared to HIV- men in unadjusted analyses (odds ratio, 0.41; 95% confidence interval [CI], 0.03-0.82; p= 0.012), there was no association between the odds of AF/AFL and HIV serostatus after adjusting for age, race, and study center (odds ratio, 0.79; 95% CI, 0.38 -1.63; p= 0.53) and after further adjustment for CVD risk factors (odds ratio, 0.88; 95% CI, 0.34 -2.24; p=0.79). There was a 6% increase in the odds of AF/AFL for each yearly increase in age after adjusting for demographics and CVD risk factors (odds ratio, 1.06; 95% CI 1.00-1.03, p<0.001), regardless of HIV serostatus.

CROI 2020 241