CROI 2025 Abstract eBook

Abstract eBook

Poster Abstracts

764

Switching to DTG/3TC vs BIC/FTC/TAF and Steatotic Liver Disease: A Sub-Study of PASODOBLE Trial Juan A. Pineda 1 , Jose L. Blanco 2 , Pere Domingo 3 , Mar Masiá 4 , Juan Tiraboschi 5 , Pilar Rincón 6 , Alexy Inciarte 2 , Paula Prieto 3 , Jordi Navarro Mercade MD, PhD 7 , Luis M. Real 6 , Maria-Jesus Vazquez 8 , Marta De Miguel 9 , Esteban Martínez 2 , Juan Macias 1 , Adrian Curran 10 , for the PASO-DOBLE Study Group 1 University of Sevilla, Sevilla, Spain, 2 Hospital Clinic of Barcelona, Barcelona, Spain, 3 Hospital de la Santa Creu i Sant Pau, Barcelona, Spain, 4 Hospital General Universitario de Elche, Elche, Spain, 5 Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain, 6 Hospital Universitario Virgen de Valme, Sevilla, Spain, 7 Hospital Universitario de la Vall d'Hebron, Barcelona, Spain, 8 ViiV Healthcare, Madrid, Spain, 9 Fundación SEIMC-GeSIDA, Madrid, Spain, 10 Hospital Universitari Vall d'Hebron, Barcelona, Spain Background: Steatotic liver disease (SLD) is a common condition in PLWH, linked to overweight and associated metabolic disorders. Both INSTIs and TAF have been associated with weight gain in clinical trials and real-life studies. Likewise, TAF has also been associated with SLD. Controversial results have been reported regarding INSTIs and SLD. In virologically suppressed PLWH, switching to DTG/3TC is non-inferior to BIC/FTC/TAF and leads to less weight gain 1 . Therefore, switching to 3TC/DTG and to BIC/FTC/TAF could have different impacts on SLD. Our aim was to compare the effect of switching to 3TC/DTG vs. BIC/FTC/TAF on SLD in PLWH. Methods: Patients from the open-label, randomized clinical trial PASODOBLE 1 were analyzed in this sub-study if: 1) were recruited by centers equipped with a vibration-controlled transient elastography (VCTE) device including CAP, and 2) measurements fulfilling quality criteria were obtained. SLD was defined as a CAP≥248 dB/m. Analyses were planned at wks. 48 and 96. Continuous variables are expressed as median (Q1-Q3). Results: Fifty-nine patients received DTG/3TC and 56 BIC/FTC/TAF. Baseline data of the patients are shown in table. At wk. 48, weight had increased by 0.45 (-1.5-3.1) kg in patients on DTG/3TC and by 1.20 (-1, 4) kg (p=0.356) in those on BIC/FTC/TAF. The corresponding figures for CAP changes were 5 (-17-24) dB/m and 6 (-12-31) dB/m (p=0.544). Among patients on DTG/3TC, 36% and 44% (p=0.225) showed SLD at baseline and at wk. 48, respectively. For those receiving BIC/FTC/TAF the corresponding data were 36% and 43% (p=0.248). Thirty-three (56%) PLWH on DTG/3TC and 32 (57%) on BIC/FTC/TAF (p=0.896) gained weight; in 12 (20%) and 18 (32%) (p=0.150), respectively, the increase was ≥5%. Among patients who gained weight, CAP rose by 5 (-21-25) dB/m in those who were on DTG/3TC and by 24 (-5-39) dB/m (p=0.192) in the BIC/FTC/ TAF arm. In this subset, the frequency of SLD increased from 30% at baseline to 36% at week 48 (p=0.564) in patients on DTG/3TC. The corresponding figures for those on BIC/FTC/TAF were 31% and 50% (p=0.034). Conclusions: Switching to DTG/3TC or BIC/FTC/TAF is associated with a trend towards an increase in the frequency of SLD. Overall, no difference exists between both regimens after 48 wks. of therapy. However, in the subset of patients who gain weight after switching, those treated with BIC/FTC/TAF show a greater increase in the frequency of SLD compared to those receiving DTG/3TC.

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Liver Steatosis Progression With Integrase Inhibitors in HIV Adults in Low-/Middle-Income Countries Marie Kerbie Plaisy 1 , Thierry Tiendrebeogo 1 , Carlotta Riebensahm 2 , Mark Kuniholm 3 , Abert Minga 4 , Gilles Wandeler 5 , Rodrigo Moreira 6 , Ephrem Mensah 7 , Gad Murenzi 8 , Ardele Mandiri 9 , Sandra Wagner Cardoso 6 , Jean Paul Mivumbi 8 , Hugo Perazzo 10 , Antoine Jaquet 1 , for the International Epidemiology Databases to Evaluate AIDS (IeDEA) Collaboration 1 University of Bordeaux, Bordeaux, France, 2 University Hospital Bern, Bern, Switzerland, 3 State University of New York at Albany, Rensselaer, NY, USA, 4 PAC-CI Program, Abidjan, Côte d'Ivoire, 5 Bern University Hospital, Bern, Switzerland, 6 Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, Brazil, 7 Centre Africain de Recherche en Épidémiologie et en Santé Publique, Lomé, Togo, 8 Rwanda Military Hospital, Kigali, Rwanda, 9 Newlands Clinic, Harare, Zimbabwe, 10 Oswaldo Cruz Foundation, Rio de Janeiro, Brazil Background: Integrase strand transfer inhibitor (INSTI)-based antiretroviral therapy (ART) regimens are widely used and linked to weight gain in some patients, potentially contributing to liver steatosis in people living with HIV (PWH). We assessed predictors of liver steatosis progression over 24 months in PWH from Low-and Middle-Income Countries (LMICs). Methods: The Sentinel Research Network (SRN)-IeDEA is a multi-regional cohort of PWH ≥40 years, on ART for ≥6 months at enrollment. Participants from Brazil, Côte d’Ivoire, Rwanda, Togo and Zimbabwe with Controlled Attenuation Parameter (CAP) measured at baseline and at month 24 by transient elastography were included. Those with viral hepatitis co-infection or hazardous alcohol intake were excluded. Liver steatosis progression was defined as the development of steatosis (≥S1, CAP ≥248 dB/m) or transition to a higher grade (moderate, CAP ≥268 dB/m; severe, ≥280 dB/m) for those with a lower stage at baseline. Generalized linear mixed regression models assessed the association between INSTI exposure and liver steatosis progression. Confounding variables such as age, sex, BMI, and Type 2 diabetes (T2DM) were adjusted based on literature and directed acyclic graphs for optimal model adjustment. INSTI exposure and confounding factors were included as fixed effects, with participating country modeled as a random effect. Results: A total of 883 participants (63% female, median age 50 years, IQR: 45–56) were included. At baseline, 56% had a BMI ≥25 kg/m², 11% had T2DM, 94% had HIV RNA <1,000 copies/mL, and 51% were on INSTI-based ART, with 84% for <2 years. Baseline liver steatosis prevalence ranged from 15% (95% CI, 10–21) in Togo to 49% (95% CI, 37–62) in Brazil. Over 2 years of follow-up, the incidence of progression was 10.2 (95% CI, 8.6–11.7) per 100 person-years. No association was found between INSTI exposure and liver steatosis progression (Table), while a positive association was noted with T2DM (aOR 1.87, 1.08-3.21) and a BMI ≥25 kg/m² (aOR 4.54, 2.94 –7.02) at baseline. Conclusions: INSTI exposure was not associated with liver steatosis progression over 24 months. Preexisting metabolic disorders, including T2DM and overweight/obesity, were predictors of liver steatosis progression, emphasizing the need for targeted prevention strategies. While INSTIs can enhance health outcomes for many PWH, long-term monitoring is crucial, particulary for those at risk for metabolic disorders.

Poster Abstracts

1 Martínez E, et al. 25th IACS. Munich 2024. Abstr OAB3606LB

766

Lipidomics of Metabolic Dysfunction-Associated Steatotic Liver Disease Post-HCV Eradication in PWH Juan Berenguer 1 , Rubén Martín-Escolano 2 , Belén Paula Fernández Requena 2 , Ana Virseda-Berdices 2 , Juan González-García 3 , Carolina González-Riano 2 , Cristina Diez 1 , Victor Hontañón 3 , Teresa Aldámiz-Echevarría 1 , Coral Barbas 2 , Salvador Resino 2 , María Angeles Jiménez-Sousa 2 1 Hospital General Universitario Gregorio Marañón, Madrid, Spain, 2 Instituto de Salud Carlos III, Madrid, Spain, 3 Hospital Universitario La Paz, Madrid, Spain Background: Although sustained virologic response (SVR) following direct-acting antiviral (DAA) therapy is a key goal in treating hepatitis C, some patients continue to experience liver disease progression despite HCV clearance. Metabolic dysfunction-associated steatotic liver disease (MASLD)

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