CROI 2025 Abstract eBook

Abstract eBook

Poster Abstracts

>90 days on a COPD inhaler medication. Plasma biomarkers were measured at a single timepoint between 2010-2018 among a subset of virally suppressed PWH; substance use data were collected through November 2023. Biomarkers were log-transformed and scaled by standard deviation. We used relative risk regression to estimate associations between biomarker levels and COPD, adjusted for age, sex, CD4 count, and smoking status (never, ever, missing) with sampling weights to account for the sampling design of the biomarker study. Results: Among 1425 PWH, average age was 47 (SD: 11), and 17% were female. Nearly half (48%) of PWH were non-Hispanic Black and 39% were non-Hispanic White. There were 242 (17%) cases of COPD, and PWH with COPD were older on average and reported more substance use, including smoking. Higher kynurenine/tryptophan [KT] ratio was associated with a 21% greater likelihood of having COPD (Prevalence Ratio [PR]: 1.21; 95%CI: 1.06-1.37). Additional markers of generalized inflammation were associated with COPD including suPAR (PR: 1.23; 95%CI: 1.06-1.42), ICAM-1 (PR: 1.18; 95%CI: 1.04-1.35), sTNFR1 (PR: 1.14; 95%CI: 1.02-1.29), and IL-6 (PR: 1.15; 95%CI: 1.00-1.33) (Table). These findings were consistent with additional adjustment for cannabis use and illicit drug (methamphetamine, cocaine, opioid) use. Conclusions: We found a novel association between elevated levels of KT ratio and COPD in PWH. Markers of generalized inflammation were also increased in PWH with COPD. An elevated KT ratio has been linked with infections including active tuberculosis and SARS-CoV-2, suggesting chronic inflammatory and microbial stimuli may contribute to the pathogenesis of COPD in PWH.

H. capsulatum or Cryptococcus spp . infections. Viral (n=6 [26%], including influenza and SARS-CoV-2) and mycobacterial infections (n=6 [26%]) were the second most common trigger, followed by neoplastic processes (n=4 [17%]) such as Hodgkin lymphoma and non-Hodgkin lymphoma. CMV and EBV VL were positive in 5 (22%) and 6 (26%) subjects respectively. Multiple coinfections were presented in 16 (70%) participants with 11 (48%) having two coinfections and 5 (22%) having more than two. In bone biopsies, erythrophagocytosis was confirmed in 9 (39%) individuals. EBER was performed in 4 bone marrow biopsies, all being positive (Figure 1). Conclusions: HLH confers high risk of mortality. In this study, HLH was presented in a context of high HIV VL, low CD4 count, and multiple coinfections. Since mortality was a common outcome, HLH should be considered in critically ill HIV patients. The figure, table, or graphic for this abstract has been removed. Safety of Full-Spectrum Cannabidiol for PWH: A Double-Blind, Randomized, Placebo-Controlled Study Clémence Couton 1 , Mathilde Wanneveich 2 , Barbara De Dieuleveult 2 , Elodie Pougoue Touko 2 , Chloé Robin 1 , Helene Klein 3 , Kossi Ayena 1 , Alicia Harry 1 , Elodie Villalonga-Rosso 1 , Laurent Hocqueloux 2 , Lucile Mollet 1 , Thierry Prazuck 2 1 Centre de Biophysique Moléculaire, Orléans, France, 2 Centre Hospitalier Régional d'Orléans, Orléans, France, 3 Little Green Pharma, West Perth, Australia Background: People with long-term controlled HIV (PWH) suffer from inflammaging, characterized by chronic inflammation and immunosenescence. As cannabis smokers display immune beneficial effects such as lower levels of inflammation and as the popularity of cannabidiol (CBD) products increases, we evaluated the safety of a full-spectrum cannabidiol drug for the first time on PWH. The new results presented herein are in direct link with our previously published analyses showing limited impact on health-related quality of life. Methods: This double-blind, randomized, placebo-controlled trial was registered on ClinicalTrials.gov as NCT05306249. Eighty ART-treated PWH with undetectable viremia (median time on efficient ART 14 years, median age 54 year-old), were included, encompassing 30% women. Half took 1mg/kg twice a day of a full-spectrum, pharmaceutical grade, CBD oil for 12 weeks and the other half took a placebo medium-chain triglyceride oil. An additional follow up was done at week 16. We evaluated the treatment impact on hemodynamic with electrocardiograms, HIV follow up and both liver and kidney functions were assessed with whole blood dosages. Results: No significant difference in adverse events, whether mild or serious, were detected between the CBD arm (58) and the placebo one (57). We highlighted that there was also no change in plasmatic viral load, DNA proviral levels and CD4/CD8 ratio. Systolic and diastolic blood pressure (SBP and DBP) were not impacted by the treatment as well. Interestingly, for men but not for women, median heart rate was lowered from 71.1 to 64 bpm after 12 weeks of CBD treatment, and persisted until at least 4 more weeks. Moreover, the safety of the full-spectrum drug on kidney and liver was evidenced with no significant effect on creatininemia, ASAT, ALAT and conjugated bilirubin levels. Yet, a mixed model, considering time and group, showed that total bilirubin rate was lowered after 12 weeks of CBD intake. Conclusions: To conclude, pharmaceutical grade full-spectrum CBD oil, at 1mg/ kg twice a day, is not associated with any impaired function or adverse events but other studies found that, at high doses, hepatic deleterious effects can occur. This suggests that, at a low dose, it could be safe for PWH with potential beneficial effects on total bilirubin and men heart rate. Higher Mortality Following SARS-CoV-2 Infection in Rural Dwellers Persists 2 Years After Infection Jerrod Anzalone 1 , Michael T. Vest 2 , Makayla E. Schissel 1 , Brad Price 3 , Lucio Miele 4 , San Chu 5 , Sally L. Hodder 3 , for the National COVID Cohort Collaborative (N3C) 1 University of Nebraska Medical Center, Omaha, NE, USA, 2 Christiana Care Health Services, Newark, DE, USA, 3 West Virginia University, Morgantown, WV, USA, 4 Louisiana State University, New Orleans, LA, USA, 5 Pennington Biomedical Research Center, Baton Rouge, LA, USA Background: Rural regions in the U.S. have unique health challenges, including higher socioeconomic inequalities, greater comorbidity prevalence, and limited healthcare access. Previous work has demonstrated that these challenges extend to COVID-19, with rural residents having worse acute outcomes after SARS-CoV-2 infection. However, the longer-term impact of COVID-19 on rural residents remains uncertain. This study analyzed post-COVID-19 short- and long-term mortality by rural residency in a large U.S. cohort.

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Poster Abstracts

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Characteristics of Secondary Hemophagocytic Lymphohistiocytosis in People Living With HIV/AIDS Xavier A. Flores-Andrade 1 , Amy B. Peralta-Prado 1 , Alvaro López-Iñiguez 2 , Gonzalo Salgado-Montes de Oca 1 , Jesús Delgado-de la Mora 3 , Andrea Cárdenas Ortega 1 , Alberto Magallanes-López 4 , Angel G. Vargas-Ruiz 1 , Ana P. Rodriguez Zulueta 4 , Ethel Cesarman 3 , Santiago Avila Rios 5 1 National Institute of Respiratory Diseases, Mexico City, Mexico, 2 Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico, 3 Weill Cornell Medicine, New York, NY, USA, 4 Hospital General Dr Manuel Gea Gonzalez, Mexico City, Mexico, 5 Instituto Nacional de Enfermedades Infecciosas, Mexico City, Mexico Background: Hemophagocytic lymphohistiocytosis (HLH), commonly known as hemophagocytic syndrome, is a rare and serious disease triggered by a myriad of stimuli. HLH is characterized by an uncontrolled cytokine production and persistent lymphocyte and macrophage activation which results in hemophagocytosis. Since people living with human immunodeficiency virus (PLWH) have an increased risk of coinfections, HLH has great relevance in the clinical field as it worsens patient's prognosis. Methods: We conducted a descriptive retrospective study to elucidate the main characteristics of secondary HLH in PLWH. This study included 23 participants with more than 90% probability for HLH by HSCORE, enrolled from three HIV reference centers in Mexico City from January 2019 to December 2023. Clinical and microbiological data were collected from clinical records, as well as bone diagnostic biopsies to perform Epstein–Barr virus–encoded small RNAs (EBER) by in situ hybridization, and to confirm infectious or neoplastic diseases. Results: From 23 participants, 4 (17%) were cisgender women, 3 (13%) transgender women, and 16 (70%) cisgender men. Median HIV viral load (VL) was 5.48 (IQR=2.69-6.47) log copies/mL, and the median CD4 T cell count was 24.50 (IQR=15-65) cells/mL. Immune reconstitution inflammatory syndrome was presented in 5 (22%) individuals, and 8 (35%) died. Fungal diseases were the most common trigger (n=14 [61%] individuals) which included

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CROI 2025 286