CROI 2025 Abstract eBook

Abstract eBook

Poster Abstracts

with and without cognitive impairment at baseline in a cohort of virologically suppressed older PWH. Methods: Virologically suppressed Thai PWH aged 50 years or older were enrolled between 2015 and 2017. Cognitive performance was assessed at enrollment using the Thai-validated Montreal Cognitive Assessment (MoCA), with a score of <25 indicating cognitive impairment. Follow-up MoCA assessments began in 2021. A multivariate linear mixed-effects model, with an interaction term between baseline cognitive status and follow-up time, was used to estimate differences in cognitive performance changes over time between those who were cognitively impaired and unimpaired at baseline. Results: Among 287 PWH included (38.0% female, median age 54.5 [IQR: 52.0–59.4] years, 25.4% with six years or less education, median HIV duration of 18.1 [IQR: 14.9–20.9] years), 61.3% had cognitive impairment at baseline. PWH with baseline cognitive impairment were significantly older, more likely to be female, and had less education. The median interval between the two MoCA was 5.9 (IQR: 5.6–6.8). After adjusting for age, sex, body mass index, education, smoking, alcohol consumption, diabetes, hypertension, low-density lipoproteins, depression, HIV duration, nadir CD4 levels, and exposure to efavirenz, cognitively unimpaired PWH at baseline showed a greater decline in cognitive performance compared to those with baseline cognitive impairment, with a difference in MoCA score of -2.4 (95%CI -2.9 to -1.9) for the cognitively unimpaired group, compared to +0.3 (95%CI -0.1 to 0.7) for the cognitively impaired group over 6 years ( P -interaction<0.001) ( Figure ). Notably, delayed recall was the only MoCA subdomain where the cognitive trajectory differed significantly between the two groups ( P -interaction<0.001). Conclusions: Despite initially better cognitive performance, virologically suppressed older Thai adults with HIV who were cognitively unimpaired at baseline showed greater cognitive decline compared to those with baseline cognitive impairment. Investigating the potential role of dynamic lifestyle factors and underlying causes of cognitive impairment could help explain these unexpected findings.

p<0.05). Age, gender, education level and HIV clinics were retained due to their importance, independently of significance. Results: The median age of the 290 PLWH included in this study was 58 years (IQR: 53-62), 67% were female, 68% had a low education level, 50% had hypertension, 63% had dyslipidemia, 14% were diabetic, 6.5% had depressive symptoms, 9.5% had a detectable viral load (<50 copies/ml) and the median CD4 was 690 cell/mm3 (IQR: 500-900). In the final model, low IST-15-seconds scores were significantly associated with hypertension (β=-0.3, p=0.01), female sex (β=-0.8, p= <0.001), low educational level (β=-0.3, p=0.05) and HIV-clinics (β=-0.6, p=<0.001). No association was observed in this final model with other sociodemographic characteristics (i.e. age, marital status or professional activity), cardiometabolic disorders (i.e. diabetes or dyslipidemia) and specific HIV clinical outcomes (i.e. CD4 count or viral load). Conclusions: Among older West African PLWH, after adjusting for usual socio demographic determinants, low verbal fluency performance was associated with hypertension. This underscores the urgent need for effective hypertension monitoring and treatment in this population, given the high prevalence of hypertension.

Poster Abstracts

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No Evidence of a Detrimental Effect of Pitavastatin on Neurocognitive Function Among People With HIV Kristine M. Erlandson 1 , Ashley McKhann 2 , Doug Kitch 2 , Frank Palella 3 , Ronald Ellis 4 , Beau Ances 5 , Markella V. Zanni 6 , Marissa Diggs 6 , Gerald Bloomfield 7 , Carl Fichtenbaum 8 , Judith Aberg 9 , Pamela Douglas 7 , Heather Ribaudo 2 , Steven Grinspoon 6 1 University of Colorado Anschutz Medical Campus, Aurora, CO, USA, 2 Harvard TH Chan School of Public Health, Boston, MA, USA, 3 Northwestern University, Chicago, IL, USA, 4 University of California San Diego Medical Center, La Jolla, CA, USA, 5 Washington University, St Louis, MO, USA, 6 Massachusetts General Hospital, Boston, MA, USA, 7 Duke Clinical Research Institute, Durham, NC, USA, 8 University of Cincinnati Medical Center, Cincinnati, OH, USA, 9 Icahn School of Medicine at Mount Sinai, New York, NY, USA Background: Equipoise exists regarding the effect of statins on cognitive function, with some observational studies suggesting harm and others suggesting benefit. Limited data among people with HIV (PWH) may be biased by indication for statin prescription. Methods: To assess statin effects on neurocognitive function among PWH, we leveraged data from participants co-enrolled in REPRIEVE (RCT of statin therapy vs. placebo) and HAILO (observational study including serial assessments of neurocognitive function). All co-enrolled participants with ≥1 measure of neurocognitive function before (median 7) and after enrollment (median 3) into REPRIEVE were included. Neurological function was determined by NPZ-4, the average of the Z scores from: Hopkins Verbal Learning Test Revised (HVLT-R), Trailmaking A and B (TrA, TrB), and Digit Symbol Test (DST) every 48 weeks. NPZ-4 and its component tests were analyzed with general estimating equation models using an exchangeable working correlation structure, with trajectories before and after REPRIEVE randomization estimated separately. Results: Of 181 co-enrolled participants (pitavastatin 88, placebo 93), the mean (SD) age was 50.3 (5.0) years, 19% female at birth, 31% Black, 23% Hispanic, and 24% had current cigarette use. Characteristics were balanced between randomized groups. Changes in overall and individual neurocognitive scores were small, not meeting threshold for clinically relevant (<0.5), and similar in the placebo and pitavastatin arms (Table). In bivariate analyses adjusting for demographics, comorbidities, and cardiovascular risk factors, the effect sizes were minimally changed and remained non-significant. Although subgroup analyses were limited by a small sample size, we observed trends

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Hypertension: A Major Factor in Low Verbal Fluency Among People Aged 50+ Living With HIV in Senegal Caroline Couturier 1 , Hèlène Font 2 , Marie Kerbie Plaisy 2 , Ababacar Niang 3 , Judicaël Malick Tine 3 , Jean-François Dartigues 1 , Nathalie De Rekeneire 4 , Moussa Seydi 3 , Ndeye Fatou Ngom 3 , Antoine Jaquet 2 , Charlotte Bernard 1 1 L'Université de Bordeaux, Bordeaux, France, 2 University of Bordeaux, Bordeaux, France, 3 Centre Hospitalier Universitaire de Fann, Dakar, Senegal, 4 Pasteur Institute in Cambodia, Phnom Penh, Cambodia Background: Decline in verbal fluency, observed both in aging and HIV infection, is associated with reduced quality of life. The association of cardiometabolic diseases with verbal fluency is well described in Western Countries, not in Sub-Saharan Africa, especially in older people living with HIV (PLWH). This study aims to identify the factors associated with verbal fluency performance in older PLWH in West Africa. Methods: PLWH aged ≥50 years and on antiretroviral therapy since ≥6 months were enrolled as part of a prospective, longitudinal, multicenter study conducted at two HIV-clinics (SMIT, CTA) in Dakar, Senegal. Sociodemographic characteristics, depressive symptoms and cardio-metabolic disorders including hypertension, diabetes and dyslipidemia were measured at enrollment. Verbal fluency was assessed with the Isaacs Set Test (IST) which consists in giving as many words as possible from a specific semantic category (« animals ») in 15 seconds. Factors associated with verbal fluency performance at enrollment were evaluated with multivariate linear regressions (backward selection, significance

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