CROI 2024 Abstract eBook

Abstract eBook

Oral Abstracts

PWH <50y than ≥50y (Interaction P=0.02) but no significant difference by sex. Adjusting for baseline antidepressant use did not change the main estimate (aHR 1.16, P=0.02). New onset depressive symptoms were associated with the highest stroke risk among different patterns of depressive symptoms: none/ mild (referent), new onset (aHR 1.93, P=0.009), remitted (aHR 1.31, P=0.3), persistent (aHR 1.31, P=0.1). Conclusion: Higher severity depressive symptoms were associated with higher stroke risk with greater impact in younger PWH. Stroke risk was considerably elevated with new onset depression. Findings suggest depression may be a modifiable stroke risk factor and potential benefits of early screening and interventions for depression, especially for younger PWH and those with new onset depression.

estimated using Logan graphical analysis with metabolite-corrected arterial input function. Regional VT values were compared between serostatus groups (adjusting for TSPO rs6971 genotype) using a linear mixed model with repeated measures. Partial correlations were conducted between ROIs and CC/declarative memory assessments controlling for TSPO genotype. Results: Higher [11C]DPA-713 VT values in CC and DM ROIs were found in VS-PWH vs. controls (P<0.05), with similar magnitude of group difference across the ROIs. In VS-PWH, but not controls, higher [11C]DPA- 713 VT in CC regions associated with greater subjective complaints of impulsivity and distractibility (see Figure). Higher VT in CC regions also related to objective measures of CC (Flanker; go-no/go) in each group. For declarative memory, reported forgetfulness but not declarative memory performance associated with higher [11C]DPA-713 VT in PFC in VS-PWH. Conclusion: Higher [11C]DPA-713 VT in CC regions associated with subjective impulsivity and distractibility and lower performance on CC measures. Localized microglial activation in the lPFC, dACC, and IPL may contribute to lower CC in VS-PWH. In contrast, associations with declarative memory were not evident.

Oral Abstracts

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Carotid Inflammation on FDG-PET Is Associated With Lower Cognitive Function in Treated HIV Infection Meg Wilson 1 , Shady Abohashem 2 , Ahmed A. Tawakol 2 , Priscilla Y. Hsue 1 , Felicia C. Chow 1 1 University of California San Francisco, San Francisco, CA, USA, 2 Massachusetts General Hospital, Boston, MA, USA Background: Studies investigating the relationship between cardiovascular disease (CVD) and cognition in people with HIV (PWH) have largely focused on CVD risk factors and cerebral small vessel disease. We examined the relationship between subclinical carotid arterial inflammation on 18F-fluorodeoxyglucose (FDG)- PET and cognitive function in PWH. Methods: ART-treated PWH at moderate to high CVD risk underwent PET/CT of the neck and chest, from which we calculated FDG uptake in the carotid arteries and ascending aorta. Participants completed a battery of neuropsychological tests (Hopkins Verbal Learning Test-Revised, Digit Symbol, Grooved Pegboard, Trail Making Test Parts A & B, Stroop, Letter Fluency) and stress measures within 2 weeks of the PET scan. Z scores were created by comparing raw scores to age, sex, ethnicity, and education-matched norms and then averaged into a global cognitive summary score. In addition to individual CVD risk factors, we devised a CVD risk score reflecting the total number of CVD risk factors (history of heart disease or stroke, hypertension, diabetes, dyslipidemia, or current smoking) per participant. We used partial correlations to examine the relationship between arterial inflammation and global cognition adjusted for age, race, and education. Results: Forty-seven PWH (mean age 60, 98% men) with undetectable viral load were included. Carotid inflammation was negatively correlated with global cognition (r=-0.32, p=0.037), even after adjusting for CVD risk (r=-0.34, p=0.029). In contrast, aorta inflammation was not associated with global cognition (r=-0.05, p=0.75). Current smoking was the only individual CVD risk factor that correlated significantly with global cognition (r=-0.35, p=0.018). The correlation between carotid inflammation and global cognition was slightly attenuated after adjusting for current smoking (r=-0.30, p=0.055). Of stress measures that correlated significantly with global cognition (post-traumatic stress, r=-0.47, p=<0.001; early childhood stress, r=-0.43, p=0.003), the negative correlation between carotid inflammation and global cognition remained significant after accounting for post-traumatic (r=-0.33, p=0.033) but not early childhood stress (r=-0.25, p=0.10). Conclusion: Carotid but not aorta inflammation was negatively correlated with global cognition independent of CVD risk. Future studies should focus on identifying upstream factors that may be targeted to reduce carotid inflammation and potentially preserve cognitive health in PWH.

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Associations Between Depressive Symptom Severity and Incident Stroke Among People With HIV Jimmy Ma 1 , Robin M. Nance 1 , David Tirschwell 1 , Stephanie A. Ruderman 1 , Lydia N. Drumright 1 , Maile Karris 2 , Lyndsey S. Mixson 1 , Joseph Zunt 1 , Felicia C. Chow 3 , Barbara M. Gripshover 4 , Emily Ho 1 , Richard D. Moore 5 , Joseph A. Delaney 1 , Heidi M. Crane 1 , for the Center for AIDS Research Network of Integrated Clinical Systems 1 University of Washington, Seattle, WA, USA, 2 University of California San Diego, La Jolla, CA, USA, 3 University of California San Francisco, San Francisco, CA, USA, 4 University Hospitals Cleveland Medical Center, Cleveland, OH, USA, 5 The Johns Hopkins University, Baltimore, MD, USA Background: Among people with HIV (PWH), depression is a common psychiatric condition and an independent stroke risk factor. To clarify potential pathways in this association, we examined different levels and patterns of depressive symptom severity and incident stroke in PWH. Methods: We studied adult PWH in clinical care at 5 US sites in the CFAR Network of Integrated Clinical Systems (CNICS) cohort with ≥1 assessment for self-reported depressive symptoms (PHQ-9) through 2022. Neurologists centrally adjudicated all strokes. Participants were followed from the closest encounter on/after the first PHQ-9 measure until stroke, death, loss to follow up, or study end. A PHQ-9 score ≥10 was a positive screen for depression. We used adjusted Cox models to evaluate (1) associations between time-varying depressive symptom severity and incident stroke, (2) moderation of this relationship by age and sex, and (3) different patterns of depressive symptom severity. Patterns were based on whether the baseline and next PHQ-9 measure (median time between measures 224 days, IQR 140-461) had a positive screen for depression: (1) none/mild: negative screens for both, (2) new onset: negative then positive screen, (3) remitted: positive then negative screen, (4) persistent: positive screens for both. Results: Among 13817 PWH, at baseline, mean follow up was 7.6 years [SD 3.5], mean age was 45 years [SD 11], 19% were female, 58% reported non white race/ethnicity, 78% had HIV RNA <200 copies/mL, and 23% screened positive for depression. A total of 173 had an incident stroke during follow up. Time-varying depressive symptom severity (per 5-pt PHQ-9 score) was associated with higher stroke risk (aHR 1.16, P=0.01) with greater impact in

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CROI 2024