CROI 2025 Abstract eBook

Abstract eBook

Poster Abstracts

79.7%), and NPV= 61.4% (49%-72.8%). For the OST among men, the same threshold of -1 yielded a S= 28.6% (3.67%-71%), Sp=97.1% (90.1%-99.7%), PPV= 50% (6.76%-93.2%), and NPV= 93.2% (84.7%-97.7%). Conclusions: This is the first study validating two screening tools for osteoporosis among PLWH.SCORE showed acceptable S and NPV, while OST showed greater Sp. Consequently, in low-resource settings such as Peru, SCORE may be more suitable for identifying high-risk patients for further evaluation and management of osteoporosis. Prevalence, Incidence, and Correlates of Autoimmune Diseases in People With HIV From 1997 to 2023 Emanuela Zappulo 1 , Alessandro Tavelli 2 , Giulia Micheli 3 , Cristina Seguiti 4 , Sara De Benedittis 2 , Adriana Cervo MD 5 , Giordano Madeddu 6 , Giuseppe Lapadula 7 , Roberta Gagliardini 3 , Miriam Lichtner 8 , Andrea Gori 9 , Giulia Marchetti 10 , Antonella Castagna 11 , Antonella d'Arminio Monforte 2 , for the Icona Foundation Study Group 1 University of Naples Federico II, Naples, Italy, 2 Icona Foundation, Milan, Italy, 3 National Institute for Infectious Diseases L Spallanzani, Rome, Italy, 4 Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy, 5 University of Modena and Reggio Emilia, Modena, Italy, 6 University of Sassari, Sassari, Italy, 7 University of Milano–Bicocca, Milan, Italy, 8 Sapienza University of Rome, Rome, Italy, 9 Luigi Sacco University Hospital, Milan, Italy, 10 University of Milan, Milan, Italy, 11 IRCCS San Raffaele Scientific Institute, Milan, Italy Background: The combination of immune dysfunction in PWH and the development of inflammatory-autoimmune diseases (IADs) are apparently paradoxical yet very intriguing. Prevalence data on IADs in ART era are diverging. Multiple systemic immune-inflammation scores have emerged as novel predictive markers of IADs. Methods: We led a retrospective study on PWH followed in 1997-2023 in the ICONA cohort. We investigated the prevalence at enrolment and in follow-up and incidence of IADs. Adjusted Cox regression model (including age, calendar ART period, sex, CD4) was used to explore baseline determinants of time to IADs from ART start. We used a nested case-control study comparing PWH with new diagnosis of IADs post-ART with up to 5 age-, sex- and ART duration-matched controls to investigate the roles on IADs onset of indirect markers of inflammation (divided by tertiles of distribution), current CD4, CD4/CD8, HIV-RNA and cumulative exposure to ART classes by adjusted conditional logistic models. Results: A total of 466 IADs were diagnosed in 449/20.495 PWH (2.2%,multiple IADs in 15 individuals). Psoriasis was the most commonly reported (38%), followed by autoimmune thyroiditis (16%), ulcerative colitis (14%) and Crohn’s disease (7%). Most PWH showed this comorbidity at enrolment(60%). During follow-up, the prevalence of IADs among PWH increased from 1.4% in 1997 2002 to 2.5% in 2017-2023(p<.001). 143 new IADs occurred post-ART, with an incidence rate of 1.21/1000PYFU [95%CI:1.02-1.43]. In the adjusted Cox model, females (aHR 1.59, 95%CI:1.12 2.27) and PWH aged 50-59 years at ART start (vs<50, aHR 1.77, 95%CI:1.16-2.70) had a higher risk of IAD. In the adjusted case-control analysis, concentrations in the highest tertile of monocyte/lymphocyte ratio (MLR, aOR 1.82) and exposure to PI class (per 1-year more,aOR 1.09) were significantly related to IADs, whereas INSTI was inversely associated (per 1-year more,aOR 0.84); low current CD4 count and CD4/CD8 ratio were marginally associated (Table 1). Conclusions: IAD is a relatively rare comorbidity in PWH yet increasing in recent years. Females and PWH aged 50-59 have higher risk, as occurring in general population. High current MLR and -marginally- low current CD4 and CD4/CD8, as indicative of residual inflammation and immune dysregulation, are associated with IAD post-ART. The impact of different ART classes on IADs onset might be related to complex interplays between drug potency and toxicity and the persistent immune activation triggered by chronic HIV infection.

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Disparities in Hospitalization Among People in the HIV Outpatient Study, United States 2008-2022 Jun Li 1 , Qingjiang Hou 2 , Frank Palella 3 , Rick Novack 4 , Alexander Ewing 1 , Ellen Tedaldi 5 , Cynthia Mayer 6 , Cynthia Frinhaber 7 , Kalliope Chagaris 2 , Kimberly Carlson 2 , Kate Buchacz 1 , for the HIV Outpatient Study 1 Centers for Disease Control and Prevention, Atlanta, GA, USA, 2 Cerner Corporation, Kansas City, MO, USA, 3 Northwestern University, Chicago, IL, USA, 4 University of Illinois at Chicago, Chicago, IL, USA, 5 Temple University, Philadelphia, PA, USA, 6 St Joseph's Hospital Comprehensive Research Institute, Tampa, FL, USA, 7 Vivent Health, Milwaukee, WI, USA Background: Hospitalization rates are an important clinical indicator to monitor treatment effectiveness and the complications of antiretroviral therapy and advanced HIV disease, and provide an endpoint for morbidity among people with HIV (PWH). We examined sociodemographic and clinical disparities in hospitalization rates among PWH in the HIV Outpatient Study (HOPS), a demographically diverse, multi-city cohort across the United States. Methods: We analyzed medical records data from HOPS patients with ≥ 2 clinical encounters from 2008-2022. We assessed all-cause, HIV/AIDS-related, and non-HIV/AIDS-related hospitalization rates over time. Multivariable Poisson regression with generalized estimating equations examined sociodemographic and clinical differences in all-cause hospitalization rates. Results: Of 5434 eligible patients, 2502 (46.0%) were non-Hispanic (NH) White, 1917 (35.3%) NH Black, and 802 (14.8%) Hispanic persons. Most were ≤50 years old (73.4%) at baseline (the later of either 1/1/2008 or the first HOPS visit), privately insured (51.4%), and men who have sex with men (MSM 59.1%). During a median follow-up of 5.5 years, 5261 hospitalizations occurred, with a rate of 14.8 per 100 person-year (PY), largely with non-HIV/AIDS-related causes (87.6%). The all-cause hospitalization rates (95% confidence interval) per 100 PY declined from 12.7 (11.0,14.7) in 2008 to 9.7 (8.2,11.4) in 2010, increased to 16.9 (14.6,19.5) in 2014 (peak), then slightly decreased to 13.9 (11.8,16.3) in 2018 and leveled off and measured 14.1 (11.3,17.4) in 2022. Non-HIV/AIDS related hospitalization rates showed a similar temporal pattern. Multivariable factors positively associated (P <0.05) with hospitalization included NH-Black and Hispanic race/ethnicity (vs. NH White), MSM (vs. heterosexual HIV risk group), public, self-pay, and other insurances (vs. private), higher HIV viral load and lower CD4 cell count prior to hospitalization, and certain comorbid conditions including cancer, liver and cardiovascular diseases; however, sex was not associated (Figure). Conclusions: While hospitalization rates have declined for HOPS PWH in the past fifteen years, they continue to disproportionately affect persons who are Black, Hispanic, with more advanced HIV disease, and without private insurance. Addressing disparities by ensuring equitable access to services for the prevention and management of HIV disease and comorbidities can improve health outcomes for PWH.

Poster Abstracts

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