CROI 2025 Abstract eBook

Abstract eBook

Poster Abstracts

years of 2010-2019 to calculate rates of 10 cancer types among Black, Hispanic, and White PWHWID. Other racial/ethnic groups could not be included due to the limited number of PWHWID with cancer in our study. We estimated age standardized rates (ASR) and rate ratios using Poisson regression, with Black PWHWID as the reference. Results: There were 3,252 incident cancers from 2010-2019 among 151,669 PWHWID. Among PWHWID, the largest racial/ethnic group was Black PWHWID (41.6%), followed by Hispanic (35.7%), and White (17.3%) PWHWID. Among Black PWHWID, the highest incidence rates were for lung, liver, and prostate cancers, and among both Hispanic and White PWHWID, Non-Hodgkin lymphoma, lung, and liver cancers had the highest rates. Cancer rates varied substantially among PWHWID across racial/ethnic groups. Compared to Black PWHWID, White PWHWID had a 23% increase in lung cancer incidence, and Hispanic PWHWID had a 34% decrease in lung cancer incidence. Compared to Black PWHWID, prostate cancer rates were 61% lower in White PWID and 47% lower in Hispanic PWID. Rates of anal cancer were elevated among Hispanic PWHWID, a 67% increase compared to Black PWHWID. Conclusions: PWHWID, are at a particularly high risk of certain cancer types, especially cancers of the lung and liver, likely reflecting the high prevalence of smoking and hepatitis C in PWID compared to other HIV risk groups. Significant differences in incidence rates between racial/ethnic groups exist and more work is warranted to better understand targeted interventions (e.g., prevention efforts in HPV, reduction in HCV, and removing barriers to care) to reduce the disparities by cancer type among PWHWID. Cancer Incidence in Women With HIV in Europe and Australia: A Combined D:A:D and Respond Analysis Win Min Han 1 , Lauren Greenberg 2 , Alisa Timiryasova 2 , Lene Ryom 2 , Bastian Neesgaard 2 , for the D:A:D and RESPOND Collaborations 1 Kirby Institute, Sydney, Australia, 2 Centre of Excellence for Health, Immunity and Infections, Copenhagen, Denmark Background: Data are limited on the incidence of cancers and associated risk factors among women with HIV and were hence investigated in two large international HIV cohort collaborations – D:A:D and RESPOND, between 2006 and 2022. Methods: We included all women (sex assigned at birth) ≥18 years and investigated the incidence and risk factors of the most common cancers combined (i.e., lung, breast, non-Hodgkin’s lymphoma, cervical, anal, head & neck and other non-cervical gynecological cancers), specifically for women (breast, cervical and other gynecological cancers) and HPV-related cancers (cervical, head & neck, other non-cervical HPV-related gynecological and anal cancers). Baseline was defined as the latest of the date into a local cohort enrolment, or 1st January 2006 for the D:A:D cohort, and 1st January 2012 for the RESPOND cohort. Crude incidence rates (95% confidence intervals, CI) of each cancer group were determined and multivariable Poisson regression with robust standard errors was used to assess factors associated with incident cancers. Results: Among 17,512 women included, median age was 39.5 years at baseline, most were from cohorts in Western Europe (45%), with 27% being ART-naïve overall. Median (interquartile range, IQR) baseline and pre-ART nadir CD4 count was 458 (306-654) and 223 (110-363) cells/µL and 21% had prior AIDS diagnosis. During 141,404 person-years (PY) and a median 9.2 (5.5-10.1) years of follow-up, 539 had one of the common cancers (149 breast, 91 lung and 83 cervical, 70 NHL, 58 non-cervical gynecological, 46 head & neck and 42 anal cancers); incidence rate 3.8 [95%CI, 3.5-4.2]/100 PY, 291 had a women-specific cancer (2.1 [1.8-2.3]/100 PY) and 163 had a HPV-related cancer (1.1 [1.0-1.3]/100 PY) ( Figure ). In adjusted analyses, age 45-55 and >55 (vs. <45) years, history of injecting drug use, Southern Europe (vs. Western Europe) and current smoking were associated with an increased risk of the most common cancers. Lower

pre-ART nadir CD4 count, time-updated CD4 count, and AIDS events were associated with an increased risk of the most common cancers, HPV-related and lung cancers. Conclusions: The most common incident cancers in women with HIV in the combined D:A:D and RESPOND collaborations were breast, lung and cervical cancers. Our study suggests that particularly immunosuppressed women with HIV older than 40 years who have a history of injection drug use and are current smokers should be considered for intensified cancer prevention measures and cancer screening.

Poster Abstracts

804

Low-Level HIV Viremia Increases Immunosuppressive Markers Elevating Cancer and CVD Risk in InSTI Era Violeta Lara-Aguilar 1 , Óscar Brochado-Kith 1 , Manuel Llamas-Adan 1 , Sergio Grande García 1 , Sonia Arca De Lafuente 1 , Ignacio de los Santos 2 , Coral Sainz Pinós 1 , Mario Alía 1 , Carmen Prado 1 , Amanda Fernández Rodríguez 1 , Ricardo Madrid 1 , Luz Martín-Carbonero 3 , Verónica Briz 1 1 Instituto de Salud Carlos III, Madrid, Spain, 2 Hospital Universitario de La Princesa, Madrid, Spain, 3 Hospital Universitario La Paz, Madrid, Spain Background: We previously reported that low-level viremia (LLV) (50-200 copies/mL) increases cellular activation and senescence in people with HIV (PWH), phenomena closely related to the development of cancer and cardiovascular diseases (CVD). However, data on the clinical consequences of LLV remain limited, especially in the integrase strand transfer inhibitors (INSTI) era. Our aim was to explore how LLV impacts on soluble and cellular markers related to these pathologies. Methods: Cross-sectional observational study in 81 matched participants: 27 PWH with LLV, 27 PWH with suppressed viremia (SV) and 27 non-HIV controls (NHC). 28 immune checkpoints (ICs) and 18 cardiometabolic markers were evaluated in plasma by immunoassays. Tregs cells were characterized by spectral flow cytometry. Differences between groups were adjusted by age, sex at birth and antiretroviral therapy (ART). P-values were corrected by FDR. Results: The cohort consisted mainly of males (95%) with a mean age of 53 years. The main ART was INSTIs-based (74% in LLV and 48% in SV). PWH groups showed a generalized higher level of soluble ICs over NHC, highlighting the IDO and Arginase-1 enzymes, as well as the members of the B7 (CD80 and PD-L1), CD28 (PD1 and BTLA), TNF/RSF (TNFRSF9), MHC-I (MICA and ULBP4), MACPF (Perforin-1) and Ig (LAG-3) superfamilies ( Fig.1 ). They also revealed higher levels of the cardiometabolic markers NGAL, P-selectin, vWF and ST2. Compared to SV, LLV group showed a significant increase of sIDO, an immunosuppressive enzyme that inhibits effector T-cell functions and facilitates cell death through tryptophan degradation. They also showed a 1.4-fold increase of highly suppressive Treg FoxP3+Helios+ cells, targets also used for immune-oncology therapy. LLV also revealed higher levels of the subclinical atherosclerosis markers sICAM-1 and an upward trend of sCD14 ( Fig.1 ).

803

CROI 2025 240