CROI 2025 Abstract eBook

Abstract eBook

Poster Abstracts

event after starting TRIO was 5.8 per 100 person-years (95% CI: 4.3-7.8). 94 (75%) PWH were virally suppressed while on TRIO. Of these, 56 switched during subsequent follow-up (29 to a simplified regimen, most commonly DRV/ETV, 25 of whom remained virally suppressed). Conclusions: The most common outcome after starting TRIO was to switch to another ≥3 drug regimen. These patients had few options to switch to less burdensome regimens.

While only 36% of BL viremic PWH fully suppressed, most remained on FTR at end of follow up. CD4 recovery was similar between suppressed and viremic PWH.

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Effectiveness of Antiretroviral Therapy in People With and Without TB in the IeDEA Cohort Lea Faure 1 , Eugène Messou 2 , Oliver Ezechi 3 , Marcel Yotebieng 4 , Kathryn Anastos 4 , Pélagie D. Babakazo 5 , Dominique M. Nsonde 6 , Antoine Jean-Juste 7 , Eduardo Gotuzzo 8 , Timothy Sterling 9 , Carina Cesar 10 , Olivier Marcy 1 , Nathalie De Castro 11 , for the International Epidemiology Databases to Evaluate AIDS (IeDEA) Collaboration 1 University of Bordeaux, Bordeaux, France, 2 PAC-CI Program, Abidjan, Côte d'Ivoire, 3 Nigerian Institute of Medical Research, Lagos, Nigeria, 4 Albert Einstein College of Medicine, Bronx, NY, USA, 5 University of Kinshasa, Kinshasa, Democratic Republic of Congo, 6 Centre de Traitement Ambulatoire de Brazzaville, Brazzaville, Republic of Congo, 7 GHESKIO Center, Port-au-Prince, Haiti, 8 University Peruana Cayetano Heredia, Lima, Peru, 9 Vanderbilt University Medical Center, Nashville, TN, USA, 10 Fundación Huésped, Buenos Aires, Argentina, 11 Hôpital Saint-Louis, Paris, France Background: The efficacy of antiretroviral therapy (ART) regimens used to treat people with HIV (PWH) on concomitant tuberculosis (TB) treatment has been evaluated in few clinical trials or programmatic data. We sought to assess virologic response 1 year after ART initiation in ART-naïve PWH with and without TB within the International epidemiology Databases to Evaluate AIDS (IeDEA). Methods: We conducted a retrospective analysis of individual data collected between January 2013 and November 2022. Concomitant TB was defined as TB reported at ART initiation or after ≥1 visit during the first 6 months on ART. Data from 15 sites from the Caribbean, Central and South America, Central and West African IeDEA regions were analyzed to evaluate the proportion of participants with virologic response defined as HIV-1 RNA <1,000 copies/mL 1 year after ART initiation. Results: 54,276 ART-naïve PWH started ART, 3,944 with and 50,332 without concomitant TB. Overall, median age was 35.4 (IQR 28.5-43.7) years; 54% were females. At ART initiation, median CD4 count and HIV-1 RNA were 211 (IQR 35–392) cells/mm 3 and 4.9 (IQR 4.3 – 5.5) log 10 copies/mL, respectively. People with TB had lower CD4 and higher HIV-1 RNA at ART initiation (table 1). Overall, 10,036 (18%) started dolutegravir, 40,481 (75%) efavirenz, and 3,759 (7%) other ART regimens. One year after ART initiation, 21,084 (39%) achieved HIV-1 RNA <1,000 copies/mL and 3,703 (7%) had HIV-1 RNA ≥1,000 copies/ mL, 29,489 (54%) had no virologic data, including 1,346 (3%) who died, 8,900 (16%) who had no HIV-1 RNA available and 19,243 (35%) who were lost-to follow-up. Characteristics of participants with and without virologic data were similar. Of the 24,245 participants with HIV-1 RNA available, the proportion of participants achieving HIV-1 RNA <1,000 copies/mL were 1,238/1448 (85%; 95% CI: 84%-87%) and 19,846/22,797 (87%; 95% CI: 88%-87%) people with and without concomitant TB, respectively. Virologic response rates were 90% (95% CI 90%-91%) on dolutegravir and 86% on efavirenz (CI 85%-86%). Conclusions: Virologic response and non-response rates 1 year after ART initiation were similar among PWH with or without TB. Dolutegravir and efavirenz-based ART provided high virologic response rates. However, more than 50% of people starting ART had no virologic data available, including large numbers lost to follow-up, which is a concern to properly identify virological failure and prevent HIV related morbidity and mortality.

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Characteristics and Treatment Outcomes of People With HIV Prescribed Fostemsavir in The Trio Cohort Andrew Frick 1 , Cassidy E. Henegar 2 , Moti Ramgopal 3 , Janna Radtchenko 1 , Isobel McEwen 1 , Valeria Duran 1 , Leigh Ragone 2 , Michael Aboud 2 , Steven Santiago 4 , Greg Huhn 5 , Karam Mounzer 6 , Charles Walworth 7 , Richard A. Elion 1 , Vani Vannappagari 2 1 Trio Health, Louisville, CO, USA, 2 ViiV Healthcare, Durham, NC, USA, 3 Midway Immunology and Research Center, Fort Pierce, FL, USA, 4 Care Resource, Miami, FL, USA, 5 Ruth M Rothstein CORE Center of Cook County, Chicago, IL, USA, 6 Philadelphia FIGHT, Philadelphia, PA, USA, 7 Monogram Biosciences, South San Francisco, CA, USA Background: Fostemsavir [FTR] is approved for use with other active antiretrovirals [ARVs] for treatment of heavily treatment-experienced people with HIV [PWH] and multi-drug resistance [MDR]. We described characteristics and treatment outcomes among PWH prescribed FTR in a real-world setting in the US. Methods: PWH initiating FTR from July 2020 (FDA approval) to June 2023 identified from electronic health records in the Trio Health HIV Cohort were followed for 12 months [mo] from first FTR prescription (baseline [BL]). Analyses were stratified by viral load [VL] at BL (suppressed: VL <50 copies/mL [cpm]; viremic: VL ≥50 cpm). Outcomes included suppression (VL <50 cpm), virologic failure ([VF]: 2 consecutive VL ≥200 cpm or 1 VL ≥200 cpm + FTR discontinuation within 4 mo), and CD4 recovery (CD4 > 350 cells/ µ L or +50 cells/ µ L per 6 months on FTR). We defined BL ARV class resistance as intermediate/ high resistance to ≥ 1 ARV in a class by Stanford HIVdb algorithm, and MDR HIV as resistance to ≥ 3 ARV classes. Results: Of 82 PWH initiating FTR, 46 (56%) were viremic at BL, 31 (38%) suppressed, 5 (6%) with unknown BL VL; 79% received FTR with an integrase inhibitor. Among viremic PWH, 54% initiated FTR as part of a new ARV regimen, while 70% suppressed PWH added FTR to an existing regimen. Compared to suppressed PWH, viremic PWH receiving FTR were younger (48% < 50 yrs vs. 10%), more likely to be female (26% vs. 10%), Black race (54% vs. 23%), and BL CD4 <350 cells/ µ L (62% vs. 52%). BL resistance data was available for 63% viremic and 39% suppressed PWH: 76% viremic had resistance to ≥ 1 ARV class (vs. 67% suppressed) and 31% had MDR HIV (vs. 17%). Of 82 PWH, 69% were on FTR at the end of follow-up (65% viremic; 71% suppressed), 16% discontinued FTR (11% viremic; 23% suppressed), and 16% were lost to follow-up (24% viremic; 6% suppressed). Of PWH with VLs on FTR, 36% (14/39) of BL viremic became suppressed during the study period; 77% (20/26) of BL suppressed maintained suppression and 12% (3/26) had VF. Median (IQR) CD4 increase was 24 (0-55) cells/ µ L in BL viremic vs. 58 (24-106) in BL suppressed. Among PWH with BL CD4 < 350 cells/ µ L, CD4 recovery was similar (36% BL viremic vs. 38% BL suppressed). Conclusions: In routine clinical care, FTR was prescribed to a heterogeneous population. Most BL suppressed PWH maintained suppression over follow up.

Poster Abstracts

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