CROI 2025 Abstract eBook

Abstract eBook

Poster Abstracts

Results: We enrolled 703 PWH with a median age 62 years; 63% were males, 49% were pre-frail and 6% frail. The median time to complete the 10-TaGA was 7.53 minutes (IQR:5.72-9.48). Overall, 10-TaGA scores in the domains of social support, functionality, cognitive status, depressive symptoms, nutritional status, and gait speed had significant association with traditional assessments (p value for all <0.05). Total 10-TaGA scores significantly correlated with FFP (Spearman’s Rho 0.42, 95% confidence interval [CI] 0.35-0.47) and was highly predictive of frailty (area under the ROC curve = 0.94; Figure). Total 10-TaGA score ≥0.3 presented the best balance between sensitivity (93%) and specificity (82%) to detect PWH who are frail. Conclusions: The 10-TaGA is an efficient, valid instrument for rapid comprehensive geriatric assessment and frailty/prefrailty determination among PWH. Highly applicable in HIV clinical practice, 10-TaGA warrants further investigation as a tool to identify prefrailty/frailty and to prevent adverse health outcomes in older PWH.

non-AIDS defining cancer (NADC), and (2) liver, renal, and chronic respiratory disease. Methods: We used clinical and administrative health data from a population based cohort study that included virtually all people with HIV in BC. We assessed cause-specific non-communicable disease mortality between April 1, 1996 and March 31, 2020, distinguishing mortality from (1) CVD and NADC, and from (2) liver, renal, and chronic respiratory disease (defined using ICD 9 and 10 codes). Using competing risk Cox regression, we modelled the association between female sex and mortality rates from each of these categories. We adjusted for baseline age and socio-structural factors: history of injection drug use, residence in Vancouver’s inner city, living in a rural area, and area-level income. We also adjusted for CD4 count at antiretroviral therapy (ART) initiation. Results: A total of 11,738 males (baseline age 38 [IQR 32-46]) and 2,534 females (baseline age 34 [IQR 28,42]) with HIV were included; 92% and 88%, respectively, ever initiated ART. Over the study period, 587 males (5.0%) and 99 females (3.9%) died of CVD and NADC; 117 males (1.0%) and 53 females (2.1%) died from renal, liver, and respiratory disease. After age-adjustment, female sex was associated with a higher hazard ratio for mortality from CVD and NADC (1.18, 95% CI 0.95-1.47), but not significant, and significantly from renal, liver, and respiratory disease (2.84, 95% CI 2.05-3.97). After adjusting for socio-structural factors and CD4 count at ART initiation, female sex remained significantly associated with mortality from renal, liver, and chronic respiratory disease (Table 1). Conclusions: The higher hazard for mortality from liver, renal, and chronic respiratory disease among females with HIV in BC could not be explained by socio-structural disparities and immune status at ART initiation. Our findings highlight the need for directed public health efforts, including preventive strategies and screening, for these diseases among females with HIV. These results should be explored in other settings. 10-Minute Targeted Geriatric Assessment Identifies Vulnerable and Frail Older Persons With HIV Marilia Bordignon Antonio 1 , Jessica Castilho 2 , Paridhi Ranadive 2 , Thiago Silva Torres 3 , Vanessa Gama 3 , Sandra Wagner Cardoso 3 , Roberta Schiavon Nogueira 4 , Jose Valdez Madruga 4 , Carlos Brites 5 , Estela Luz 6 , Bryan Shepherd 2 , Vivian I. Avelino-Silva 7 , Marlon Aliberti 1 , for the ELEA-Brasil Cohort 1 University of São Paulo, São Paulo, Brazil, 2 Vanderbilt University Medical Center, Nashville, TN, USA, 3 Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, Brazil, 4 Centro de Referência e Treinamento DST/AIDS-SP, Sao Paulo, Brazil, 5 Federal University of Bahia, Salvador, Brazil, 6 Hospital Universitário Profesor Edgard Santos, Bahia, Brazil, 7 Vitalant Research Institute, San Francisco, CA, USA Background: Geriatric assessments are becoming increasingly important in HIV clinical practice as the population of older persons with HIV (PWH) expands. However, traditional instruments are often complex and time-consuming. The 10-minute geriatric assessment (10-TaGA) is a rapid, comprehensive assessment developed to screen geriatric syndromes in healthcare settings. We investigated the validity of 10-TaGA among PWH in Brazil. Methods: The Longitudinal Study of HIV & Aging in Brazil (ELEA-Brasil) enrolled PWH ≥50 years old on antiretroviral therapy for comprehensive clinical, social, and demographic data collection. Participants also completed 10-TaGA, a 10-minute assessment of domains: social support, recent hospitalization, falls, medications, ability to perform self-care activities, cognition, self-rated health, depressive symptoms, nutritional status, and mobility. 10-TaGA performance of individual domains were compared with traditional assessments using Kruskal Wallis tests.Total 10-TaGA score was correlated with Fried Frailty Phenotype (FFP) using the Spearman test. Sensitivity and specificity by 10-TaGA was measured using receiver operating characteristic (ROC) curves analyses and Youden index to define the optimal threshold for frail/prefrail discriminations.

Poster Abstracts

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The 10-Year Prevalence of Hearing Loss and Dementia Among People With HIV in the United States Ethan D. Borre 1 , Anjali Srinivasan 1 , Julie Deleger 1 , Lauren K. Dillard 2 , John Giardina 1 , Juliessa M. Pavon 3 , Sachin J. Shah 1 , Judy R. Dubno 2 , Sherri L. Smith 3 , Shibani Mukerji 1 , Kenneth A. Freedberg 1 , Howard W. Francis 3 , Christine S. Ritchie 1 , Gillian D. Sanders Schmidler 3 , Emily Hyle 1 1 Massachusetts General Hospital, Boston, MA, USA, 2 Medical University of South Carolina, Charleston, SC, USA, 3 Duke University School of Medicine, Durham, NC, USA Background: Hearing loss (HL) and age-associated dementia (AAD) are prevalent and have considerable detrimental effects on quality of life; HL is a leading preventable risk factor for dementia worldwide. As persons with HIV (PWH) age, they are at particular risk for sensorineural HL and AAD. We used simulation modeling to estimate the prevalences of HL and AAD among PWH in the US over the next 10 years. Methods: We developed the CHARMED microsimulation model of HIV and aging comorbidities in the US, including HL and AAD. We simulated a cohort of PWH engaged in HIV care and on ART at age 65 years throughout their remaining lifetimes. CHARMED includes HL prevalence at model start (28.5% for males, 12.2% for females) and age- and sex-specific annual probabilities of incident HL for persons without HL (0.1-10.4% [NHANES]). We incorporated incident AAD (0.3-10.8%) from the Adult Changes in Thought cohort. For PWH, we assumed no increased risk of HL to project conservative estimates, but included a 1.8-fold increased risk of dementia based on observational data from a Kaiser Permanente cohort. We estimated AAD incidence with and without the proportion attributable to HL by removing the estimated proportion attributable to HL (adjusted incidence risk ratio, 2.0 [95% CI, 1.5-2.8] calibrated from NHATS). For PWH, we adjusted lifetables to reflect this population’s sociodemographic characteristics. We projected age- and sex-stratified prevalences of HL and AAD, which we applied to model-projected numbers of PWH over age 65y across the next 10 years. Results: From 2023-2033, the numbers of PWH aged 65y or older would increase substantially, and most would be living with HL, AAD, or both (Figure). By 2033, of PWH aged 65y or older in the US we project that 189,300 will be males and 63,100 will be females. Of 189,300 males, 75,700 will have HL alone, 9,700 will have AAD alone, and 32,900 will have both HL and AAD. Among 63,100 females, 17,700 will have HL alone, 3,400 will have AAD alone, and 7,400 will have both HL and AAD. Conclusions: The number of PWH over 65y with HL and AAD in the US will increase substantially over the next decade. Prevention and treatment efforts,

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