CROI 2020 Abstract eBook

Abstract eBook

Poster Abstracts

months (p≤0.04). In quantile regression analyses, in YLPHIV with endothelial dysfunction, sCD14 remained associated with lower RHI after adjusting for age, sex, Tanner stage, viral load and ART duration (β-0.05, p=0.01). Conclusion: Despite viral suppression, South African YLPHIV have poor endothelial function and persistent evidence of monocyte activation and gut barrier dysfunction compared to uninfected youth. A key finding in our results is that higher sCD14 is independently associated with endothelial dysfunction in this population. The long-term clinical significance of gut integrity and monocyte activation needs to be further assessed in YLPHIV.

T-cell activation (expression of CD38 and HLA-DR on CD4+ and CD8+), as well as plasma markers of systemic inflammation, oxidized lipids, gut integrity. Results: Overall median (Q1, Q3) age was 13 years (11,15) and 52%were females. Groupswere similar by age, sex and BMI. Median CD4+ cell counts were 988 cells/µL (638, 1308), 86% had viral load < 20 copies/mL and median ART duration was 10 years (8, 11). 72%were on an NNRTI based regimen. PHIVs were more likely to have traditional CVD risk factors including higher waist-hip ratio, triglycerides, and insulin resistance (p≤ 0.03). Median IMT was slightly thicker in PHIVs compared to controls, while PWV did not differ between groups (Figure). PHIVs had higher monocyte and T-cell activation; higher CD14 (p<0.01), higher frequencies of non-classical monocytes (p=0.02) and activated CD4+ and CD8+ T-cells (p<0.001 for both). In univariate analyses, lower BMI and oxidized LDL, and higher waist-hip ratio, hsCRP and zonulin correlated with thicker IMT in PHIV (p≤0.05). After adjustment for age, BMI, sex, CD4 cell count, triglycerides, HOMA, sCD163 and hsCRP were added separately, higher levels of intestinal permeability (zonulin) remained associated with IMT (β=0.02, p≤0.03). Conclusion: Our study shows for the first time that African PHIV with viral suppression have evidence of worse CVD risk, structural vascular disease, ongoing immune activation and a leaky gut compared to age matched uninfected children. Gut barrier dysfunction may be involved in the pathogenesis of subclinical vascular disease in this population.

Poster Abstracts

832 DEPRESSION ASSOCIATED WITH LOWER EXECUTIVE FUNCTIONING IN ASIAN YOUTH LIVING WITH HIV Wipaporn Natalie Songtaweesin 1 , Christina Chandra 2 , Jiratchaya Sophonphan 3 , Ly Penh Sun 4 , Pradthana Ounchanum 5 , Pope Kosalaraksa 6 , Linda Aurpibul 7 , Suparat Kanjanavanit 8 , Chaiwat Ngampiyaskul 9 , Kathleen Malee 10 , Robert Paul 11 , Jintanat Ananworanich 12 , Claude A.Mellins 13 , Thanyawee Puthanakit 1 , for the PREDICT and Resilience Study Group 1 Chulalongkorn University, Bangkok, Thailand, 2 Emory University, Atlanta, GA, USA, 3 HIV–NAT, Thai Red Cross AIDS Research Centre, Bangkok, Thailand, 4 National Centre for HIV/AIDS Dermatology and STDs, Phnom Penh, Cambodia, 5 Chiang Rai Prachanukroh Hospital, Chiang Rai, Thailand, 6 Khon Kaen University, Khon Kaen, Thailand, 7 Chiang Mai University, Chiang Mai, Thailand, 8 Nakornping Hospital, Chiang Mai, Thailand, 9 Prapokklao Hospital, Chanthaburi, Thailand, 10 Northwestern University, Chicago, IL, USA, 11 University of Missouri, Columbia, MO, USA, 12 US Military HIV Research Program, Bethesda, MD, USA, 13 Columbia University, New York, NY, USA Background: Youth with perinatally acquired HIV (YPHIV) and youth who are PHIV-exposed but uninfected (YPHEU) may be at risk for depression in the presence of HIV-related health, cognitive, and/or psychosocial challenges. Our objective is to describe the prevalence of persistent depressive symptoms (PDS) and associated factors among YPHIV, YPHEU, and youth who are HIV-unexposed

831 VASCULAR DISEASE, IMMUNE ACTIVATION, AND GUT DYSFUNCTION IN HIV+ UGANDAN CHILDREN Sahera Dirajlal-Fargo 1 , Emily Bowman 2 , Danielle Labbato 3 , Zainab Albar 1 , Christine Karungi 4 , Rashidah Nazzinda 4 , Abdus Sattar 1 , Nicholas Funderburg 2 , Cissy Kityo 4 , Victor Musiime 4 , Grace A. McComsey 3 1 Case Western Reserve University, Cleveland, OH, USA, 2 The Ohio State University, Columbus, OH, USA, 3 University Hospitals Cleveland Medical Center, Cleveland, OH, USA, 4 Joint Clinical Research Centre, Kampala, Uganda Background: Sub-Saharan Africa is facing new challenges in HIV care including management of non- communicable diseases and a growing younger generation. The risk of cardiovascular disease (CVD) and its mechanisms in children living with perinatally acquired HIV (PHIV) in sub-Saharan Africa has been understudied. Methods: Mean common carotid artery intima-media thickness (IMT) and pulse wave velocity (PWV) were evaluated in 101 PHIV and 96 HIV negative participants (HIV-). Participants were between 10-18 years of age with no active infections including tuberculosis. PHIVs were on ART with HIV-1 RNA level ≤400 copies/mL. We measured plasma (soluble CD14 and CD163) and cellular markers of monocyte activation (proportions of monocyte subsets),

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