CROI 2025 Abstract eBook

Abstract eBook

Poster Abstracts

CACS, however data on factors associated with increased CACS and MACE (except smoking and diabetes) in HIV are scarce. Although knowledge on the importance of statin use to prevent MACE is clear (REPRIEVE), cost-effective investigations and interventions to identify and manage MACE in ageing people with HIV is vital. Methods: Data were collected on all individuals with HIV, at a single centre in London, UK, who underwent a CACS between 2009-2019, including demographics, laboratory and clinical information at the time of CACS, and MACE assessed over 15 years. Descriptive statistics, univariate and multivariate regression analyses using logistic regression were performed using STATA15. Results: Of 779 individuals with a CACS, median (IQR) age at the time of CACS was 55 years (52-59), 93% were male, median number of years since HIV diagnosis was 16 (10-21), CD4 count was 639 (473-826), 5% had a detectable viral load (VL), 34% were current smokers, 12% reported alcohol intake >14 units/week, Qrisk2 was 9.6% (6.5-14.8), BMI was 25.5 (23.3-28.0) and systolic BP was 129 (120-140). Median (IQR) CACS was 2 (0-54) with median centile 25th-50th. MACE occurred in 95 individuals (10.7%): 2.7% (n=21) myocardial infarction (MI), 2.3% (n=18) stroke and 3.6% (n=28) heart failure, 5.4% (n=42, of which 8 underwent coronary artery bypass grafts) revascularisation. Other outcomes included death from any cause in 6.4% (n=50). Predictors of MI, stroke or heart failure are shown in Table 1. Conclusions: In this cohort, CACS rather than cardiovascular risk calculated by Q-risk was the strongest predictor of MACE. CACS is a useful tool in stratifying persons who would most benefit from aggressive risk factor modification and further investigation. Future understanding on whether total plaque burden on coronary CT angiography, peri-coronary fat analysis, or cardiac MRI can refine risk prediction further is needed.

sought to investigate the relationships between BMI, excess visceral abdominal fat (EVAF), and cardiovascular risk factors in PWH in the modern ART era. Methods: The Visceral Adiposity Measurement and Observations Study (VAMOS) is a multi-center observational study in PWH with long-term viral suppression and BMI ranging from 20 to 40 kg/m 2 . Participants completed study visits, labs and an abdominal computed tomography scan in the overnight fasting state. Visceral fat was quantified by a single slice at L4-L5, with EVAF defined as a visceral adipose tissue (VAT) surface area ≥130 cm 2 . CV risk was evaluated by 10-year ASCVD risk scores. Kruskal-Wallis and Dunn’s tests were performed to determine how cardiovascular risk factors differed by BMI and EVAF classifications. Results: Among the 170 participants, median (IQR) visceral fat area was 148 cm 2 (94, 218) with an EVAF prevalence of 58%. While individuals with BMI>35 kg/m 2 group had the highest prevalence of EVAF (66.7%), EVAF was present in 56.6% and 43.2% of participants with overweight (25-29.9 kg/m 2 ) and normal BMI (<25 kg/m 2 ), respectively. To explore relationships between BMI, EVAF and CV risk factors, four distinct groups were created (Table 1). A statistically significant difference in CV risk scores was found across the groups (χ²(3)=14.87, p=0.0019). Importantly, individuals with EVAF and low BMI had the highest CV risk scores among the groups, with significantly higher scores not only compared to those with low BMI without EVAF (Z value = 3.39; p=0.0039), but also to those with high BMI without EVAF (Z value = 2.75; p=0.0301). The presence of EVAF also was associated with higher HOMA-IR levels among those with low BMI (Z value = 2.85; p=0.0224). Conclusions: These data highlight the limitations of utilizing BMI alone in assessing CV risk among PWH, particularly given the high CV risk seen in participants with low BMI but high EVAF. Incorporating tools to assess EVAF, such as waist circumference, could provide critical information in identifying PWH at risk of CVD. Investigating the Predictive Role of NLR and PLR in Cardiovascular and Neurologic Outcomes in PWH Jonathan N. Tobin 1 , Yiqi Tian 1 , Megha Arora 2 , Takreem Ahmed 3 , Mariam A. Siyanbola 3 , Alondra Torres Gonzalez 3 , Kevin Fiscella 4 , Teresa H. Evering 3 1 Clinical Directors Network, New York, NY, USA, 2 The Bronx Regional Health Information Organization (BronxRHIO), Bronx, NY, USA, 3 Weill Cornell Medicine, New York, NY, USA, 4 University of Rochester Medical Center, Rochester, NY, USA Background: People living with HIV (PWH) are at an increased risk for cardiovascular disease and cerebrovascular outcomes (CVD). The Neutrophil to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR), derived from the complete blood count (CBC) commonly measured in clinical care, are emerging biomarkers of systemic inflammation. This study assesses whether adding NLR and PLR to the Atherosclerotic Cardiovascular Disease (ASCVD) risk score improves 10-year CVD prediction in PWH. Methods: This retrospective cohort study examined data from the Bronx Regional Health Information Organization, an electronic health records exchange. ASCVD risk scores, NLR, and PLR were calculated for all participants. Blood pressure, cholesterol, and CBC were aligned using the cholesterol test date as the anchor for risk score calculation. Individuals with pre-existing CVD were excluded. The primary outcome was combined incident CVD identified via ICD-9/10 codes. Logistic regression models assessed associations between HIV status, ASCVD risk, NLR, and PLR with CVD outcomes. Model performance was compared using chi-square deviance tests, with stepwise inclusion of predictors to assess improvement in predictive power. Results: The analysis cohort included 10,767 PWH and 30,296 demographically matched adults without HIV (1:3 ratio) between 2009–2019. Median age was 49 years, 45% were female, 65% Black/African American, 38% Hispanic/Latino. At baseline, compared to individuals without HIV, PWH had 15% higher odds of combined CVD (OR: 1.15, 95% CI: 1.09-1.21), increasing to 26% after adjusting for ASCVD risk (OR: 1.26, CI: 1.19-1.33). Each 1% increase in ASCVD risk increased the outcome odds by 8.3% (OR: 1.08, CI: 1.08-1.09). NLR was a significant predictor

Poster Abstracts

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BMI Is a Poor Surrogate for Excess Visceral Adiposity and Cardiovascular Risk in Persons With HIV Mohammed Zogheib 1 , John Koethe 2 , Jordan E. Lake 3 , Karam Mounzer 4 , Christian Caldji 1 , Brandon Cash 1 , Colleen McGary 1 1 Theratechnologies, Inc, Montreal, Canada, 2 Vanderbilt University Medical Center, Nashville, TN, USA, 3 University of Texas Health Science Center at Houston, Houston, TX, USA, 4 Philadelphia FIGHT, Philadelphia, PA, USA Background: Recent studies demonstrate substantial weight gain among people with HIV (PWH) starting modern antiretroviral (ART) regimens, as well as a high prevalence of obesity among those on long-term treatment. As a result, routine body mass index (BMI) measurements have been proposed to assess cardiovascular (CV) and other comorbid illness risk. However, prior studies show substantial variability in visceral abdominal fat accumulation among PWH. We

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