CROI 2024 Abstract eBook

Abstract eBook

Poster Abstracts

being associated with increased risk of multimorbidity in women but not in men. Further research is needed to mitigate the adverse consequences of LLV in men and women.

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Short- and Long-Term Body Weight Gain Following Switch to Integrase Inhibitors Differs by Sex Cecile D Lahiri 1 , Cyra C. Mehta 1 , Qian Yang 1 , Joffi Musonge-Effoe 1 , Julie B. Dumond 2 , Maria L. Alcaide 3 , Jordan E. Lake 4 , Leah H. Rubin 5 , Audrey L. French 6 , Jennifer Cocohoba 7 , Seble Kassaye 8 , Anjali Sharma 9 , Anandi N. Sheth 1 , Igho Ofotokun 1 , Jessica A. Alvarez 1 1 Emory University, Atlanta, GA, USA, 2 University of North Carolina at Chapel Hill, Chapel Hill, NC, USA, 3 University of Miami, Miami, FL, USA, 4 University of Texas Health Science Center at Houston, Houston, TX, USA, 5 The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA, 6 Stroger Hospital of Cook County, Chicago, IL, USA, 7 University of California San Francisco, San Francisco, CA, USA, 8 Georgetown University, Washington, DC, USA, 9 Montefiore Medical Center, Bronx, NY, USA Background: Integrase strand-transfer inhibitors (INSTIs) are associated with weight gain among persons with HIV (PWH), which may be more severe in women. We assessed differences in weight change by sex up to 6 years following switch to INSTIs. Methods: We used data collected between 2007-2020 in virally-suppressed (<200 c/mL) INSTI-naïve PWH on antiretroviral therapy (ART) for ≥2 years and persons without HIV (HIV-) enrolled in the MACS/WIHS Combined Cohort Study. We compared PWH who switched/added an INSTI to those who remained on non-INSTI ART and to HIV- controls. Follow-up time was years since switch visit or comparable visit in controls. Weight change was the difference between post- and pre-switch visits. Linear regression mixed effect models assessed the effects of sex (assigned at birth), group, and time on absolute and percent (%) weight change, adjusted for age, race/ethnicity, socioeconomic status, and diabetes. Results: 3466 participants contributed a mean 3.2 (±1.5) years of data, including 1940 women (411 INSTI, 711 Non-INSTI, 818 HIV-) and 1526 men (223 INSTI, 412 Non-INSTI, 891 HIV-). Compared to men, women were younger (47.2 vs 54.5 years), more likely to be non-Hispanic Black (65 vs 23%), had higher pre-switch BMI (31.5 vs 26.9 kg/m 2 ), and higher prevalence of diabetes (19 vs 13%), respectively. Absolute weight gain in women versus men was +3.2 (±9.8) vs +1.6 (±6.1) kg in INSTI, +0.8 (±9.4) vs +1.0 (±6.6) kg in non-INSTI, and +0.2 (±11.2) vs +0.2 (±7.2) kg in HIV- groups. In adjusted models, sex and group modified % weight change by time (sex*group*years interaction, p<0.0001). Men switching to INSTIs experienced greater % weight gain compared to non-INSTI and HIV- controls up to 1-2 years post-switch: +2.42% (95% CI 1.41-3.42) vs +0.58% (-0.17-1.34) and +0.58% (0.02-1.14), respectively, with no differences between groups beyond 3 years. In contrast, women on INSTIs experienced greater % weight gain for up to 3-4 years post-switch compared to women on non-INSTIs [+4.49% (95% CI 3.60-5.37) vs +2.08% (1.30-2.87)] and up to 5-6 years post-switch versus HIV- women [+5.16% (3.80-6.52) vs +0.02% (-1.24-1.28)], Figure. Conclusion: Short and long-term body weight gain in PWH switching to INSTIs differed by sex, with women experiencing a greater amount and longer duration of weight gain relative to controls. Further research is needed to understand implications of weight gain on cardiometabolic disease and support sex-specific preventative and therapeutic intervention strategies.

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Body Composition Changes Among DMPA and Non-Hormonal Users on TDF Based ART Switched to B/F/TAF Flavia Kiweewa Matovu 1 , Martin Nabwana 1 , Esther Isingel 1 , Philippa Musoke 1 , Mary G. Fowler 2 , John Pettifor 3 , Todd T. Brown 2 , Mags Beksinska 4 , for the BONE: STAR Study Team 1 Makerere University–Johns Hopkins University Research Collaboration, Kampala, Uganda, 2 The Johns Hopkins University School of Medicine, Baltimore, MD, USA, 3 University of the Witwatersrand, Johannesburg, South Africa, 4 Wits Reproductive Health and HIV Institute, Johannesburg, South Africa Background: We previously demonstrated a higher bone mass among DMPA users on tenofovir alafenamide (TAF) compared with tenofovir disoproxil fumarate (TDF) containing ART. However, concerns about metabolic complications remain. We assessed the effect of switching women living with HIV (WLWH) from TDF/ lamivudine/ dolutegravir to Bictergravir /Emtricitabine /TAF (B/F/TAF; Biktarvy®) on body composition over a two-year period in the BONE: STAR study. Methods: WLWH on TDF and DMPA-IM were randomized in a 1:1 ratio to either continue on a TDF based ART regimen (HIV+/DMPA+/TDF+) or switch to B/F/ TAF (HIV+/DMPA+/TAF+). A third group of WLWH on TDF and using non hormonal contraception were all offered B/F/TAF (HIV+/DMPA-/TAF+). Dual energy x-ray absorptiometry was used to measure lean mass, total, trunk, and extremity fat at enrollment and every 6 months for 2 years. Multivariable linear regression was used to assess differences in mean percent (%) change in fat and lean mass adjusting for age, and in body mass index. Results: A total of 346 WLWH were included in the analysis, with follow up between December 2019 and August 2023. Median age was 31 years (interquartile range, 27.9 to 34.7 years). Both non-hormonal and DMPA groups who switched to B/F/TAF had significant increases in mean lean mass, total, trunk, and extremity fat post switch, p-value <0.001. There were no significant differences were in body composition parameters between women on B/F/ TAF and DMPA or non-hormonal contraception, versus and TDF users, p>0.173. Similarly, no differences were noted between women on B/F/TAF using DMPA versus non-hormonal contraception, p>0.125. Conclusion: Significant increases were observed in fat and lean mass in both groups with no differences between DMPA users on TDF and DMPA or non-hormonal contraception switched to B/F/TAF. Longer term follow -up data beyond 2 years are needed to further understand the impact in WLWH of Sleep Apnea in People With and Without HIV in Primary Care Jennifer O Lam 1 , Craig E. Hou 2 , Stacey Alexeeff 1 , Tory Levine 1 , Varada Sarovar 1 , Verena E. Metz 1 , Michael A. Horberg 3 , Derek D. Satre 4 , Michael J. Silverberg 1 1 Kaiser Permanente Northern California, Oakland, CA, USA, 2 Kaiser Permanente Northern California, South San Francisco, CA, USA, 3 Kaiser Permanente Mid-Atlantic States, Rockville, MD, USA, 4 University of California San Francisco, San Francisco, CA, USA Background: Sleep apnea negatively impacts health and quality of life. A better understanding of potential differences in sleep apnea incidence and risk factors between people with HIV (PWH) and people without HIV (PWoH) could inform prevention and management strategies. Methods: We conducted a study of adult (≥18-years-old) members of Kaiser Permanente Northern California, an integrated U.S. healthcare system. PWH and PWoH with membership between July 2013 and December 2021 were matched different ART options on fat gain and obesity-related conditions. The figure, table, or graphic for this abstract has been removed.

Poster Abstracts

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CROI 2024 251