CROI 2025 Abstract eBook

Abstract eBook

Poster Abstracts

786

Lung Cancer Screening Eligibility and Uptake Among People With HIV: A Decade of Missed Opportunities Subhashini A. Sellers, Lindsay Browne, Heather Henderson, Claire Farel, Sonia Napravnik University of North Carolina at Chapel Hill, Chapel Hill, NC, USA Background: Lung cancer is the leading cause of malignancy-related death among PWH in the US, is diagnosed at younger ages, and with fewer pack-years (p-y), and is associated with shorter survival compared to those without HIV. Lung cancer screening (LCS) with low-dose chest CT in PWH may reduce lung cancer mortality by 19%. We evaluated LCS eligibility among PWH in the Southeastern US from 2014-2023 and contrasted annual prevalence of screening by patient characteristics. Methods: We identified PWH with ≥1 HIV clinic visit from 01/01/2014 12/31/2023 in the University of North Carolina CFAR HIV Clinical Cohort. For years 2014-21, we applied the 2013 USPSTF guidelines (age 55-80, ³30 p-y, active smoking, or quit £15 years). For years 2022-23, we applied the revised 2021 guidelines (ages 50-80, ³20 p-y, active smoking or quit £15 years). We estimated annual prevalence differences (PD) and 95% confidence intervals (CI), by patient characteristics. Results: Among 3,461 PWH, the median age at most recent clinic visit was 49 (IQR 36-59), with 64% reporting a smoking history with a median of 12.5 p-y (IQR: 5-25). From 2014-2021, LCS eligibility rose from 3 to 6% (p-trend <0.001, Figure ), further rising to 11% in 2022 and 12% 2023, following updating of USPSTF guidelines. Of the 2,215 ever-smokers, 15% (N=342) were eligible for LCS in at least one calendar year during the study period. The median age of eligible PWH was 62 years (IQR: 57-66), with median p-y of 40 (IQR 27-50), and 51% (N=173) received ≥1 CT during follow-up. Annual screening rates increased from 9 to 33% between 2014 and 2021 (p-trend <0.001), and decreased from 30% to 29% between 2022 and 2023. In 2023, for every 5-year increase in age, the likelihood of screening increased by 6% (95% CI: 1.4, 10.1), and for every 5 p-y increase in smoking, by 2% (95% CI: 0.2, 3.3). Screening was not associated with patient HIV characteristics, including HIV RNA <200 copies/mL and CD4 <200 cells/mm³. Conclusions: From 2014 to 2023, the proportion of PWH eligible for LCS has risen steadily, alongside increased screening for those at risk. Despite this growth, fewer than one-third of eligible PWH are receiving LCS. Alarmingly, the gap in screening has widened since the introduction of the 2021 USPSTF guidelines, likely due to delayed adoption. As PWH continue to age and face heightened comorbidity risk, early and consistent screening for lung cancer is vital to reducing mortality in this vulnerable population.

HBV(P) induced significant serum HBs and HBc IgG responses (P<0.0001 and P<0.01, respectively), and S/P-specific IFN-γ ELISpot responses (p<0.01, p<0.0001, respectively) compared to mock injection. We confirmed in vivo the advantage of the CD40 targeting in eliciting specific T-cell responses by comparing the CD40.HBV(S/C) with IgG4.HBV(S/C). Both vaccines activated human polyfunctional (IFN-g±IL-2±TNF) CD4+ T-cells specific to S, C, and P in vitro , with significantly enhanced responses compared to equivalent amounts of non-targeted antigens (3 ng/mL of peptide pools). CD8+ T-cell responses against HBc and HBV P were amplified in vitro in 40% of NUC-treated CHB patients. Conclusions: Two CD40-targeting vaccine candidates, incorporating 6 highly immunogenic HBV peptides, were produced with high quality and demonstrated immunogenicity in vivo , and were able to recall memory T-cell responses from PBMCs of NUC-treated CHB patients. These vaccines are promising candidates for further testing in humanized mice and for assessing their therapeutic potential.

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WITHDRAWN

Poster Abstracts

787

Immune Tumor Microenvironment of HIV-Associated Lung Cancer Reveals Immunoregulatory Features Syim Salahuddin 1 , Ramsey Yusuf 2 , Shruti Desai 3 , Lais Osmani 3 , Kishu Ranjan 3 , Jianlei Gu 3 , Insoo Kang 3 , Hongyu Zhao 3 , Yuval Kluger 3 , Kurt Schalper 3 , Brinda Emu 3 1 University of Iowa, Iowa City, IA, USA, 2 University of Miami, Miami, FL, USA, 3 Yale University, New Haven, CT, USA Background: Lung cancer is the leading cause of cancer mortality among people with HIV (PWH), with increased incidence and poor outcomes. Methods: We explored whether HIV-associated non-small cell lung cancers (NSCLC) harbor an immunoregulatory tumor microenvironment (TME) that limits tumor-specific responses. A tissue microarray was constructed with tumors from 18 PWH and 19 people without HIV (PWOH), matched for histological subtype, stage, year of diagnosis, age, sex and smoking status.

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