CROI 2020 Abstract eBook

Abstract eBook

Poster Abstracts

Background: HIV infection may accelerate aging-related comorbidity development. The incidence of non-AIDS comorbidities (NACM) in women with HIV (WWH) is poorly characterized. Methods: WWH and HIV- women in active follow-up in the Women’s Interagency HIV Study (WIHS) in 2009 (when >80% of WWH used antiretroviral therapy (ART)) or onward were included, with outcomes measured through March 31, 2018. Age, demographic and clinical covariates, and prevalent NACM were determined at enrollment. We used Poisson regression to estimate incidence rate ratios (IRR) comparing accrual of incident NACM by HIV serostatus and age using partially adjusted (age, HIV) and fully adjusted (age, HIV, covariates) models. Results: There were 3129 women (2239 HIV+, 890 HIV-) with 36,589 person-yrs (PY) of follow-up. At enrollment, median age was 37yrs, 65% were black, 47% currently smoked, and median body mass index was 28 kg/ m 2 . WWH had a median CD4 count of 484 cells/mm 3 , 69%were on ART and 45%were virologically suppressed. Of 10 NACM evaluated, mean NACM count at enrollment was higher among WWH vs HIV- women (1.4 vs 1.2, p=0.006), though only prevalent liver disease (26% vs 16%, p<0.001) and psychiatric illness (26% vs 21%, p=0.003) differed significantly by HIV serostatus. In partially adjusted models, incident NACM burden was greater in WWH vs HIV- women (0.20/PY vs 0.16/PY; IRR 1.21, 95% CI 1.13-1.29) and increased with age regardless of HIV serostatus (p<0.0001). Incidence was higher in WWH vs HIV- women for (IRR; 95% CI): chronic kidney (3.14; 1.80-5.49), liver (2.56; 1.85-3.54), psychiatric (1.38; 1.02-1.86), hyperlipidemia (1.36; 1.14-1.62) and bone disease (1.35; 1.14-1.58). The incidence of hypertension, diabetes, cardiovascular, lung disease and non-AIDS cancer did not differ significantly by HIV serostatus. In fully adjusted models, incident NACM burden was significantly higher among WWH vs HIV- women in most age strata (Figure, HIV*age interaction p=0.046). Women <25yrs had the greatest IRR at 1.50 (95% CI 1.21-1.87) vs those 25-29 (1.32; 1.10-1.58), 30-34 (1.24; 1.09-1.42), 35-39 (1.12; 1.00-1.25), 40-44 (1.03; 0.92-1.16), 45-49 (1.28; 1.07-1.53), 50-54 (1.18; 0.95-1.46), ≥55 (1.38; 1.04-1.84). Conclusion: WWH have higher baseline and incident NACM burden than HIV- women. Incident differences were most dramatic among women aged <25yrs, a group for whom routine comorbidity screening is lacking. More data are needed to inform best practices for NACM screening and management in WWH, particularly young women.

contribute to the heightened risk of NCDs among some PLWH. We characterized the risk of several NCDs among PLWH with undetectable plasma viral load, persistent low-level viremia (pLLV), and viral failure in the African Cohort Study (AFRICOS). Methods: AFRICOS is an ongoing cohort enrolling participants in 12 clinics in Uganda, Kenya, Tanzania, and Nigeria. Clinical assessments, including HIV viral load testing, are completed every six months. Participants without an NCD at baseline were included in these time-to-event analyses. PLLV was defined as at least two consecutive visits with a detectable viral load <1000 copies/mL. We examined four different NCDs: elevated blood pressure (any single systolic pressure >139, diastolic >89 mmHg, or use of anti-hypertensive medications), hypercholesterolemia (total cholesterol >199 mg/dL or lipid-lowering medications), dysglycemia (any non-fasting glucose >199 mg/dL or fasting glucose >99 mg/dL), and renal insufficiency (estimated glomerular filtration rate <60). We also evaluated the presence of any one or more of these NCDs as a dichotomized outcome variable. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazard modeling. Models were adjusted for study site, education, ART regimen, and age. Results: As of June 1, 2019, 2,872 PLWH were enrolled of which 1,773 did not have an NCD at baseline and were included in these analyses. The majority of participants were female (58%) and between 18-39 years (61%) with 12% >50 years at enrollment. Over the course of follow up, 623 (35%) participants developed any NCD, including 261 (15%) who developed elevated blood pressure, 359 (20%) hypercholesterolemia, 176 (10%) dysglycemia, and 28 (2%) renal insufficiency. Participants with pLLV developed any NCD sooner than their virally-suppressed counterparts (HR 1.49 [95% CI 1.24-1.80]). Similar associations were observed for most of the individual NCDs evaluated (Table). Conclusion: PLLV was significantly associated with NCDs in this population. Targeting viral suppression below the limit of detection on clinical HIV viral load assays may reduce the risk of non-infectious complications of HIV. 713 FACTORS ASSOCIATED WITH PSORIASIS: THE INDEPENDENT ROLE OF HLA-B*5701 Maxime Hentzien 1 , Lise Cuzin 2 , François Raffi 3 , Christine Jacomet 4 , Jacques Reynes 5 , David Rey 6 , Isabelle Ravaux 7 , Antoine Chéret 8 , Manuelle Viguier 1 , Firouze Bani-Sadr 1 1 CHU de Reims, Reims, France, 2 CHU Fort de France, Fort de France, Martinique, 3 CHU de Nantes, Nantes, France, 4 CHU de Clermont-Ferrand, Clermont-Ferrand, France, 5 CHU de Montpellier, Montpellier, France, 6 Hôpitaux Universitaires de Strasbourg, Strasbourg, France, 7 Assistance Publique–Hopitaux Marseille, Marseille, France, 8 Hôpital Bicêtre, Le Kremlin-Bicetre, France Background: Psoriasis is a T cell-mediated inflammatory disease with genetic factors involved in its aetiopathogenesis. In non-HIV population, HLA-B*5701 has been associated with a higher risk of psoriasis. The aim of this study was to study demographic and immunovirological characteristics associated with psoriasis and to assess whether HLA-B*57:01 is associated with psoriasis among patients living with HIV (PLHIV) followed in a large French multicenter cohort. Methods: All PLHIV followed up in the Dat’AIDS cohort with an available result for HLA-B*57:01 available were included. Patients with psoriasis were identified by the presence of corresponding ICD-10 codes corresponding to this disease in the database. Logistic regression models were used to identify associations between psoriasis (outcome variable) and explanatory variables. Results: Among the 31 076 PLHIV with available HLA-B*57:01 result included in the Dat’AIDS cohort from 2000 to 2018, the prevalence of psoriasis and HLA-B*57:01 were 2.25% and 4.73%, respectively. In multivariate analysis, male gender (OR 1.81 [95% CI, 1.46 – 2.24], p<10-4), positive HLA-B*57:01 (OR 2.66 [95% CI, 2.12 – 3.33], p<10-4), nadir CD4 cell count < 200/mm 3 (OR 1.41 [95% CI,

Poster Abstracts

712 PERSISTENT LOW-LEVEL VIREMIA IS ASSOCIATED WITH NONINFECTIOUS COMORBIDITIES Allahna L. Esber 1 , Julie Ake 1 , Emmanuel Bahemana 2 , Francis Kiweewa 3 , Jonah Jonah Maswai 4 , John Owuoth 4 , Michael Iroezindu 5 , Christina Polyak 1 , Trevor A. Crowell 1 , for the AFRICOS Study Group 1 US Military HIV Research Program, Silver Spring, MD, USA, 2 HJF Medical Research International, Mbeya, Tanzania, 3 Makerere University Walter Reed Project, Kampala, Uganda, 4 Kenya Medical Research Institute, Nairobi, Kenya, 5 Henry Jackson Foundation, Abuja, Nigeria Background: Despite improved life expectancy with antiretroviral therapy (ART), persons living with HIV (PLWH) have higher rates of noninfectious comorbid diseases (NCDs) than do uninfected individuals. Chronic inflammation and immune activation due to persistent low-level viral replication may

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