CROI 2024 Abstract eBook

Abstract eBook

Poster Abstracts

index, LDL levels, higher proportion of metabolic syndrome, and less frequently were living with HIV. GAHT (current and exposure), hormone levels, and FMD were not associated with liver steatosis. TGW living with HIV according to liver steatosis did not differ on nadir CD4+ count and viral load. The most common antiretroviral regimen was DTG/3TC/TDF (62.5%[10/16] and 71.9%[48/64] among TGW with steatosis and without steatosis, respectively). Six participants were on dual antiretroviral therapy with 3TC/DTG (18.8%[3/16] and 4.7%[3/64] among TGW with and without steatosis, respectively). Conclusion: Traditional factors and HIV-positive status were associated with liver steatosis among Brazilian TGW. Changes in arterial diameter and GAHT exposure were not associated with liver steatosis. Our findings reinforce the need of including traditional factors of liver steatosis for TGW's clinical assessment. This study was partially funded by ViiV Healthcare UK Ltd. The figure, table, or graphic for this abstract has been removed. Increased levels of FGF21 and GDF15 Are Associated With Severity of NAFLD in People With HIV Paula Debroy 1 , Francis Pike 2 , Samer Gawrieh 2 , Kathleen Corey 3 , Ashok Balasubramanyam 4 , Kate Ailstock 5 , Nicholas Funderburg 5 , Jordan E. Lake 1 1 University of Texas at Houston, Houston, TX, USA, 2 Indiana University, Bloomington, IN, USA, 3 Massachusetts General Hospital, Boston, MA, USA, 4 Baylor College of Medicine, Houston, TX, USA, 5 The Ohio State University, Columbus, OH, USA Background: Non-alcoholic fatty liver disease (NAFLD) poses a significant health burden in people with HIV (PWH). Fibroblast growth factor 21 (FGF21) is an important regulator of hepatic lipid and glucose metabolism. Higher levels have been associated with hepatic steatosis and liver fibrosis in the general population. Growth differentiation factor 15 (GDF15) is upregulated in chronic inflammatory diseases and associated with cardiovascular dysfunction in PWH. We aimed to describe the trends of FGF21 and GDF15 concentrations in PWH and NAFLD. Methods: Consenting PWH and no other known cause of liver disease underwent vibration-controlled transient elastography for controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) quantification at three US centers. NAFLD was defined as CAP ≥263 dB/m; advanced fibrosis as LSM > 12kPa. Fasting serum FGF21 and GDF15 were measured by ELISA. Relationships between biomarkers and NAFLD were analyzed using a Censored Tobit Model. Results: Participants (n=177) had median age 52 years and were 20% cisgender women, 81% overweight/obese, 90% virally suppressed on antiretroviral therapy. Participants with NAFLD (50%) had significantly higher mean (SD) levels of FGF21 [333 (377) vs 226 (305) pg/ml, p=0.002] and GDF15 [859 (371) vs 744 (366) pg/ml, p=0.02] than participants without NAFLD. FGF21 levels increased with BMI (p=0.04). Higher FGF21 and GDF15 levels correlated modestly with higher CAP (FGF21 r=0.30, p<0.001; GDF15 r=0.21, p=0.01) and LSM scores (FGF21 r=0.25, p<0.001; GDF15 r=0.27, p=0.01). FGF-21 concentrations were 40% higher (mean Log Difference [95% confidence interval]= 0.34 (0.06,0.62), p=0.02]) and GDF15 17% higher (0.16 [0.01,0.32], p=0.04) in persons with vs. without NAFLD. Participants with the highest FGF21 levels (quartile 4) had higher NAFLD prevalence (71% vs 39%, p=0.01), higher mean CAP (301 vs 247 dB/m, p=0.001) and LSM (6.2 vs 4.5 kPA, p=0.004) values, and longer mean duration of HIV (10 vs 17 years, p<0.001) compared to persons in quartile 1. Similar trends were seen with GDF15 level quartiles. Conclusion: PWH and NAFLD had higher levels of FGF21 and GDF15 than those without NAFLD, with higher levels correlating with greater liver steatosis and fibrosis. FGF21 and GDF15 may have a role in identifying PWH at risk of metabolic liver disease. Further research is needed to elucidate the role of these circulating factors in PWH and NAFLD and their diagnostic and prognostic value. Plasma Proteomics Signature of People Living With HIV, With NAFLD, With and Without Obesity Louise E van Eekeren 1 , Nadira Vadaq 1 , Vasiliki Matzaraki 1 , Adriana Navas 1 , Elise M. Meeder 1 , Marc Blaauw 1 , Wilhelm A. Vos 1 , Albert L. Groenendijk 2 , Gert Weijers 1 , Jan van Lunzen 1 , Mihai Netea 1 , Andre J. van der Ven 1 , Quirijn de Mast 1 , Eric T. Tjwa 1 , Leo Joosten 1 1 Radboud University Medical Center, Nijmegen, Netherlands, 2 Erasmus University Medical Center, Rotterdam, Netherlands Background: Non-alcoholic fatty liver disease (NAFLD) is a leading cause of liver-related morbidity in people living with HIV (PLHIV). Obesity is an important risk factor but NAFLD also occurs in lean PLHIV, with possible different

Bacteroides, Dialister, Acidaminococcos, Alloprevotella, and Catenibacterium. In contrast, the most enriched genera in NAFLD+ were Ruminococcus, Streptococcus, Holdemanella, Blautia, and Lactobacillus (Figure 1B) Conclusion: We found a microbiome signature linked to NAFLD, which had a greater influence on the overall structure of the gut microbiota than HIV status alone. We suggest that part of the alterations in the microbiota described as associated with HIV could be confused by the presence of NAFLD, which is more prevalent in people with HIV.

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Poster Abstracts

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Liver Steatosis Is Not Associated With Endothelial Function or Hormone Use in Transgender Women Emilia M Jalil , Rodrigo C. Moreira, Hugo Perazzo, Marcelo Cunha, Ronaldo Moreira, Laylla Monteiro, Monica D. Pedrosa, Biancka Fernandes, Valdilea Background: Transgender women (TGW) present disproportionate chronic diseases burden. Nevertheless, very little is known about inflammation related chronic diseases among TGW in low and middle-income countries (LMIC), especially in the context of HIV infection and gender-affirming hormone therapy (GAHT). We aimed to assess the association of liver steatosis with subclinical atherosclerosis measured by brachial artery flow-mediated dilatation (FMD) and GAHT. Methods: Cross-sectional study among trans women aged 18+ years of the Transcendendo cohort, Rio de Janeiro, Brazil, between October/2019-May/2023. Participants answered a structured questionnaire, collected blood samples, and performed transient liver elastography by Fibroscan and FMD. Valid elastography results were considered if: had at least 10 valid measurements, the percentage of valid measurements was >60%, and Controlled Attenuation Parameter (CAP) interquartile range (IQR)/CAP <30%. Results with CAP ≥248 dM/m were classified as liver steatosis. Percentage of FMD [(peak diameter baseline diameter)/baseline diameter] was used for analysis. Bivariate analysis compared TGW with and without liver steatosis. Results: Among 157 TGW, 131 (83.4%) had valid liver assessments. Among these, median age was 39.0 years (IQR:31.0-44.0), 80(61.0%) were living with HIV, 65(51.0%) were currently on GAHT, and 36(27.5%) had liver steatosis. Participants with steatosis were significantly older, had a higher body mass Veloso, Beatriz Grinsztejn, Sandra W. Cardoso Oswaldo Cruz Foundation - Fiocruz, Rio de Janeiro, Brazil

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