CROI 2025 Abstract eBook

Abstract eBook

Poster Abstracts

diagnosed increased from 5% to 6% and 32% and the proportion initiating treatment among those diagnosed from 43% to 33% and 80% (Figure). The proportion aviremic among those treated increased initially from 23% to 42% but then decreased in 2023-2024 to 33%. In 2024, only 8% of those with prior chronic infection were aviremic. Among PWHCV, correlates of diagnosis were older age, higher education, recent HIV testing, suppression on ART and MOUD use. Among those treated, correlates of aviremia were higher education, stable employment and suppression on ART. Conclusions: Despite increases in diagnoses and achieving WHO targets in HCV treatment uptake among those diagnosed, we observed no change in aviremia among those treated or at the population level. These findings, alongside concerning increases in HCV antibody prevalence, suggest that this level of treatment scale up was not sufficient to prevent primary infection or reinfection among actively injecting PWID.

data. The median time from HCV diagnosis to DAA initiation was 47, 30, and 15 days during the pre-campaign, campaign, and post-campaign periods, respectively (Logrank P =0.06). Conclusions: We observed a significant reduction in HCV incidence among MSM using PrEP following an HCV test and treat campaign. Additional factors, such as concurrent epidemics (COVID-19, monkeypox), changes in sexual behavior, and new recommendations for diagnosis and treatment of acute HCV infection in MSM, may also have contributed to this trend. Impact of HIV Infection on the Dynamics of Liver Stiffness After HCV Cure Jesica Martín-Carmona 1 , Anaïs Corma-Gómez 1 , Jose M. Moyano 2 , Francisco Tellez 3 , Dolores Arenga-Barrios 3 , Miriam Serrano-Fuentes 4 , Aitana Carla Morano Vázquez 5 , Diana Corona-Mata 6 , Miguel Nicolás Navarrete Lorite 7 , Francisco Jesús Vera-Méndez 8 , Isabel Barroso 9 , Rosario Palacios 10 , Juan A. Pineda 2 , Juan Macias 2 , for the GEHEP-011 Study Group 1 Hospital Universitario Virgen de Valme, Sevilla, Spain, 2 University of Sevilla, Sevilla, Spain, 3 Hospital Universitario de Puerto Real, Cadiz, Spain, 4 Hospital Universitario de Gran Canaria Dr Negrin, Las Palmas, Gran Canaria, 5 Hospital Universitario Alvaro Cunqueiro, Vigo, Spain, 6 Hospital Universitario Reina Sofia, Cordoba, Spain, 7 Hospital Universitario Virgen Macarena, Sevilla, Spain, 8 Hospital General Universitario Santa Lucía, Cartagena, Spain, 9 Hospital Universitario Jerez de la Frontera, Jerez de la Frontera, Spain, 10 Hospital Universitario Virgen de la Victoria, Málaga, Spain Background: During HCV active chronic infection, HIV co-infection promotes liver fibrogenesis and accelerates the progression towards cirrhosis. After sustained virological response (SVR), liver stiffness (LS) usually decreases, regardless of HIV co-infection. However, information related to the impact of HIV co-infection on LS dynamics in this subset is scarce. Methods: Multicenter prospective study conducted in the GEHEP-011 cohort (ID NCT04460157), including patients with chronic HCV infection, with and without HIV co-infection, fulfilling: 1) SVR with direct-acting antivirals based regimens; 2) pre-treatment LS ≥9.5kPa; 3) available measurement of LS at SVR. Pre treatment (baseline), SVR and then, annual post-treatment LS were assessed by vibration-controlled transient elastography. The primary outcome was the time to LS normalization achievement (≤7.2kPa). To control confounding biases between the two subgroups, a propensity score (PS) for HIV was calculated. Two Fine-Gray regression models for competing risks (death was the competing event) were performed: i) using the PS as a covariate; ii) matching individuals whit and without HIV co-infection by PS. ChatGPT (version GPT-4) was used for assistance with statistical coding. Results: 1,138 patients were included, 678 (60%) people living with HIV (PLWH). Median LS value at baseline (Q1-Q3) was 17.3 kPa (11.8-27.0) in PLWH and 15.4 kPa (11.8-26.4) in persons with mono-infection (p=0.170). The median time between the first to the last measure was 35 (17-69) months. LS dynamics are shown in Fig. 1. LS dynamics differed between patients with and without HIV co-infection (p < 0.001). In total, 456 (40.1%) patients achieved LS normalization (Fig. 2), 192 (42%) individuals with HCV mono-infection and 264 (21%) PLWH (p=0.003). In the multivariate analysis regression adjusted by HIV, PS and diabetes, HIV was associated with a lower probability of achieving normalization [sHR=0.70 (95% CI, 0.56-0.88), p=0.001]. Matching by closer PS was performed. In this subset, the probability of achieving LS normalization was again lower in PLWH [sHR=0.74 (95% CI, 0.60-0.92), p=0.006]. Conclusions: After SVR, the probability of reaching LS normalization is significantly lower and later in PLWH, even after an extensive adjustment for multiple potential confounders. Factors as inflammation and immunosenescence associated with HIV may be relevant in the impairment of fibrosis reversal. This could have implications on the development of long-term clinical events. The figure, table, or graphic for this abstract has been removed. Comorbidities Among Medicaid Enrollees With Chronic Hepatitis C, 2016-2020 Angela T. Estadt, Hasan Symum, William W. Thompson, Taiwo Abimbola, Michelle T. Van Handel Centers for Disease Control and Prevention, Atlanta, GA, USA Background: To achieve hepatitis C elimination in the United States (US), understanding comorbidities among people living with chronic hepatitis C is crucial to inform prevention and treatment approaches. We aimed to quantify and characterize the prevalence of HIV, sexually transmitted infections (STIs), mental health disorders, substance use disorders, and drug overdose among Medicaid enrollees diagnosed with chronic hepatitis C in the US.

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Impact of an HCV Test and Treat Campaign on Hepatitis C Incidence in the ANRS PREVENIR PrEP Study Geoffroy Liegeon 1 , Constance Delaugerre 2 , Lydie Beniguel 3 , Salima Barkat 3 , Jade Ghosn 4 , Sarah Maylin 5 , Romain Palich 5 , Gilles Pialoux 6 , Laurence Slama 5 , Mohamed Ben Mechlia 7 , Dominique Costagliola 8 , Lambert Assoumou 5 , Jean Michel Molina 1 , for the ANRS PREVENIR Study Group 1 Université Paris Cité, Paris, France, 2 Hôpital Saint-Louis, Paris, France, 3 Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France, 4 Hôpital Bichat-Claude-Bernard, Paris, France, 5 Assistance Publique – Hôpitaux de Paris, Paris, France, 6 Hôpital Tenon, Paris, France, 7 France Recherche Nord & Sud Sida-HIV Hépatites, Paris, France, 8 Institut national de la santé et de la recherche médicale (Inserm), Paris, France Background: Men who have sex with men (MSM) on HIV pre-exposure prophylaxis (PrEP) have an increased risk of hepatitis C virus (HCV) infection. We assessed the impact of a test-and-treat campaign using HCV nucleic acid (NAT) and core antigen (cAg) testing in reducing the HCV incidence among MSM in the French ANRS PREVENIR study. Methods: The ANRS PREVENIR study, launched in 2017, is an ongoing prospective cohort study of PrEP users in the Paris region, where participants are annually tested for HCV antibodies. From January 2020, all participants were offered HCV NAT and Ag testing in an initial 3-month campaign extended to June 2021 due to the COVID-19 pandemic. All participants with positive HCV NAT were immediately treated by direct-acting antiviral (DAA). We compared HCV incidence (95% confidence interval) and time to treatment initiation during the testing campaign (January 2020-June 2021) with the pre-campaign (May 2017– December 2019) and post-campaign (July 2021–May 2024) periods. Results: From May 2017 to May 2024, 3050 participants contributed to the pre campaign period, 2286 to the testing campaign, and 1824 to the post-campaign period, for a total of 4184, 2960, and 3709 person-years of follow-up per period, respectively. Most were MSM (98%), median age 36, and 14% reported chemsex. During the HCV testing campaign, 1567/2286 (69%) of participants were tested with HCV NAT, 1387/2286 (61%) with cAg, and 1578/2286 (69%) with HCV serology. HCV incidence significantly declined over the study periods: 7.9 (5.4, 11.1), 5.1 (2.8, 8.4), and 3.0 (1.5, 5.3) per 1000 person-years, pre-, during, and post-campaign, respectively ( P =0.01). Among the 59 incident HCV infections (including 3 reinfections) reported during the study, 4 of the 15 diagnosed during the testing campaign were only detected by NAT. Of the 59 HCV infections, 50 (85%) were treated with DAA (48 cured, 2 unknown outcomes), 8 (14%) cleared without treatment, and 1 had missing treatment

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