CROI 2020 Abstract eBook

Abstract eBook

Poster Abstracts

893 HCV, AIDS, LIVING IN US SOUTH ARE RISK FACTORS FOR MORTALITY IN HIV+ SUBSTANCE USERS Mamta K. Jain 1 , Mark A. Vasquez 1 , Lauren Gooden 2 , Rui Duan 3 , C. Mindy Nelson 3 , Daniel J. Feaster 3 , Ank E. Nijhawan 1 , Jonathan Colasanti 4 , Meg Sullivan 5 , Allan Rodriguez 3 , Gerogina Osorio 6 , Robrina Walker 1 , Petra Jacobs 7 , Carlos del Rio 4 , Lisa R. Metsch 2 1 University of Texas Southwestern, Dallas, TX, USA, 2 Columbia University, New York, NY, USA, 3 University of Miami, Miami, FL, USA, 4 Emory University, Atlanta, GA, USA, 5 Boston University, Boston, MA, USA, 6 Icahn School of Medicine at Mt Sinai, New York, NY, USA, 7 NIH, Bethesda, MD, USA Background: Hospitalized HIV substance users were enrolled into Project HOPE to evaluate the effect of patient navigation (PN) vs. PN with financial incentives vs. usual care on HIV viral suppression. Those who provided consent for future contact were invited to participate in a follow-up study to evaluate hepatitis C virus (HCV) infection and the impact of care facilitation vs. usual care on progression along the HCV care continuum. We examined overall mortality and predictors of death which occurred during the primary study and through the end of the follow-up study. Methods: Retrospective cohort study conducted among 801 HIV-infected participants enrolled in Project HOPE between July 2012 and January 2014; they were followed for a maximum of 62 months. Kaplan-Meier estimates with a Renyi type test were used for the survival curves and an Accelerated Failure Time (AFT) model assuming a log logistic distribution was used to examine predictors of all-cause mortality. Results: Participants were 33%women, 73% black, 59% lived in the South, 40% had

892 MORTALITY AMONG PERSONS WITH HIV WITH A HISTORY OF INJECTION DRUG USE, NEW YORK CITY Chitra Ramaswamy 1 , Sarah L. Braunstein 1 1 New York City Department of Health and Mental Hygiene, Long Island City, NY, USA Background: Persons with HIV (PWH) who reported a history of injection drug use (IDU) have disproportionately higher mortality than those who did not report a history of IDU despite decreasing trends in all-cause mortality as well as new HIV diagnoses. Methods: We used New York City (NYC) Surveillance data for PWH age ≥20 years and alive at end of 2017 or who died during 2008-2017, and data on underlying cause of death for decedents from the Vital Statistics Registry or National Death Index, to examine the characteristics, cause of death and age- standardized mortality rates of PWH with a history of IDU. Results: There were 145,799 PWH included in the analysis, representing 1,192,752 person-years. Of these, 25,144 (17%) reported a history of IDU, of whom 6,733 (27%) died by the end of 2017. Although mortality rates decreased substantially among NYC PWH overall and among all transmission risk groups during 2008-2017, the mortality rate was persistently higher among PWH with IDU history compared to PWH in other HIV transmission risk groups (Figure 1). Of decedents with IDU history, nearly nine out of ten were either non-Hispanic Black or Hispanic (88%), nearly half were age 50-59 years (44%; median age 55 (Interquartile range: 47-61)), and nearly two-thirds lived in high or very high poverty neighborhoods (62%). Of IDU PWH decedents, nearly two-thirds (60%) died from a non-HIV-related cause and 39% died from an HIV-related cause. The top causes of non-HIV-related deaths were cancer (n=976, 24%; liver and lung most common) and cardiovascular diseases (CVD) (n=946, 24%; ischemic heart disease and hypertensive heart disease most common). After adjusting for demographic factors, PWH with IDU history age 50-59 (hazard ratio (HR) 1.6, 95% CI 1.5-1.8), Hispanics (HR 1.5, 95% CI 1.4-1.7) and those living in high or very high poverty neighborhoods (HR 1.4, 95% CI 1.3-1.5) had higher risk of death. Conclusion: Although it declined, mortality among NYC PWH with IDU history remained high during 2008-2017. Older IDU PWH, Hispanic IDU PWH and IDU PWH living in high poverty neighborhoods had elevated mortality risk. Since over a third of deaths were due to HIV, improvement in HIV outcomes in this population should reduce HIV-related mortality. Additionally, interventions are needed for IDU PWH to reduce the prevalence of factors such as smoking, high-risk sexual behaviors, and co-infections such as hepatitis C given their role in CVD- and cancer-related mortality.

Poster Abstracts

894 HIGH MORTALITY RATE AMONGST HIV INFECTED PEOPLE WHO INJECT DRUGS (PWID) IN SCOTLAND Rebecca Metcalfe 1 , Andrew McAuley 2 , Saket Priyadarshi 1 , Laura Sills 1 , Sharon Hutchinson 3 1 NHS Greater Glasgow and Clyde, Glasgow, UK, 2 Health Protection Scotland, Glasgow, UK, 3 Glasgow Caledonian University, Glasgow, Scotland Background: Globally almost 18% of people who inject drugs (PWID) are living with HIV and HIV related mortality has decreased over time, with availability of antiretroviral therapy (ART). Non-AIDS mortality in high income settings is estimated at 2.34 per 100 person years (1.80-2.89) and drug-related death

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