CROI 2025 Abstract eBook

Abstract eBook

Poster Abstracts

987

Sleep Patterns in South African Pregnant Women Living With HIV on Dolutegravir: A Prospective Study Hayli Geffen 1 , Jennifer Jao 2 , Hlengiwe Madlala 1 , Sandisiwe M. M. Matyesini 1 , Elton Mukonda 1 , Landon Myer 1 , Elaine Abrams 3 1 University of Cape Town, Cape Town, South Africa, 2 Northwestern University, Chicago, IL, USA, 3 Columbia University Irving Medical Center, New York, NY, USA Background: Adverse sleep patterns are common in people living with HIV generally and have been associated specifically with dolutegravir (DTG) use in studies from high-income countries. Pregnancy and obesity are both known to adversely affect women’s sleep, however there are few data assessing the impact of HIV/DTG on sleep patterns among pregnant women in Africa. Methods: The ORCHID cohort follows pregnant women recruited from primary care clinics from the beginning of antenatal care, including women living with HIV (WLH) on tenofovir/lamivudine/DTG (TLD) and HIV-seronegative (HIV-) women. Sleep patterns were assessed at 24-28w gestation using the Pittsburgh Sleep Quality Index (PSQI). Sleep apnoea risk was assessed using the Berlin Questionnaire. Anthropometric data were collected and gestational dating was via research ultrasound. PSQI global and subscale scores were calculated for: good sleep (PSQI ≤5), recommended onset latency (≤20mins), duration (≥7hrs), efficiency (>85%), good quality and daytime dysfunction. Apnoea risk was defined as Berlin score=2. Logistic regression assessed the associations between (i) HIV and (ii) TLD duration (either initiating <28d before study enrolment or continuing for ≥28d before enrolment) and sleep patterns, adjusted for age and employment, and stratified by body mass index (BMI) (under/normal weight [BMI<25] and overweight/obese [BMI≥25]). Results: Overall 1746 women were included: 1010 HIV- women and 736 WLH (197 initiating TLD, 539 continuing TLD; mean age 28y, mean BMI 31kg/m2; 29% employed). Compared to HIV- women, WLH had similar overall PSQI scores, and similar sleep latency, duration and efficiency. However WLH reported significantly better sleep quality (aOR: 1.27, 95%CI: 1.04,1.54) and significantly reduced daytime dysfunction (aOR: 0.78, 95%CI: 0.61,0.99) compared to HIV- women. These associations were most marked in WLH who were overweight/ obese (Figure). Among WLH, women initiating TLD had higher sleep efficiency than women continuing TLD (aOR: 1.45; 95%CI:1.04,2.05) but similar sleep patterns on all other measures. Conclusions: In this novel investigation of sleep in pregnant WLH, adverse sleep patterns during the second trimester of pregnancy appeared less common in WLH receiving TLD compared to HIV- women in this setting. Ongoing follow up is required to understand how sleep patterns vary in WLH over time and the implications of sleep patterns for their long-term health.

988

Prior Pregnancy Affects Aging-Related Non-AIDS Comorbidity Burden in US Women With and Without HIV Lauren F. Collins 1 , Cyra C. Mehta 1 , Jordan E. Lake 2 , Seble Kassaye 3 , Kathryn Anastos 4 , Tonya N. Taylor 5 , Elizabeth F. Topper 6 , Michelle Floris-Moore 7 , Margaret Fischl 8 , Mirjam-Colette Kempf 9 , Audrey L. French 10 , Frank Palella 11 , Ighovwerha Ofotokun 1 , Anandi N. Sheth 1 , Phyllis Tien 12 1 Emory University, Atlanta, GA, USA, 2 University of Texas Health Science Center at Houston, Houston, TX, USA, 3 Georgetown University, Washington, DC, USA, 4 Albert Einstein College of Medicine, Bronx, NY, USA, 5 SUNY Downstate Medical Center, Brooklyn, NY, USA, 6 The Johns Hopkins University, Baltimore, MD, USA, 7 University of North Carolina at Chapel Hill, Chapel Hill, NC, USA, 8 University of Miami, Miami, FL, USA, 9 University of Alabama at Birmingham, Birmingham, AL, USA, 10 Stroger Hospital of Cook County, Chicago, IL, USA, 11 Northwestern University, Chicago, IL, USA, 12 University of California San Francisco, San Francisco, CA, USA Background: Women vs men with HIV have a higher burden of aging-related multimorbidity, which may be related to reproductive transitions including pregnancy history. Methods: We evaluated longitudinal data collected from women with and without HIV (WWH; WWoH) enrolled in the Women’s Interagency HIV Study and in follow-up on/after 2009 (when >80% of WWH consistently used antiretroviral therapy). We ascertained maternal age, number of prior live births (parity) and non-AIDS comorbidity (NACM) burden (of 10 assessed) at end of observation (latest 3/30/2020). Two-sample t-test compared NACM burden by HIV serostatus. Linear regression evaluated the association of parity with NACM burden. Within each age group, separate linear regression models assessed for synergistic effects of HIV and parity on NACM burden, adjusting for race/ ethnicity, body mass index (BMI), and smoking. Results: Among 3234 women, 71% were WWH, median age was 51 (Q1-Q3 44-57) years, 65% identified as Black race, median BMI was 30.2 (Q1-Q3 25.5 36.2) kg/m 2 and 68% reported ever smoking cigarettes. At end of observation, 19%, 40%, and 41% of women reported 0, 1-2 and ≥3 prior live births; parity did not significantly differ by HIV serostatus ( p =0.13). Median NACM burden was 4.0 vs 3.0 among WWH vs. WWoH ( p <0.001). Among all women, the most prevalent NACM were hypertension (69%), psychiatric illness (55%) and dyslipidemia (42%). The estimated median NACM burden among women with 0, 1-2, ≥3 prior live births was 3.0, 3.0, and 4.0, respectively. In unadjusted analysis, parity was significantly associated with NACM burden ( p for trend =0.02), regardless of HIV serostatus. In adjusted models, HIV modified the effect of parity (HIV*parity interaction) on NACM burden in certain age groups: <40yrs ( p =0.29), 40-49yrs ( p =0.02), 50-59yrs ( p =0.39), ≥60yrs ( p =0.93) (Figure). Conclusions: In a large cohort of U.S. women with and without HIV, who had a high burden of aging-related comorbidities and >80% reporting ≥1 prior live birth, greater parity was associated with NACM burden. This effect was significantly modified by HIV among women aged 40-49 years, with some evidence of modification by HIV as women age. Our findings suggest parity may be a potential risk factor for aging-related multimorbidity and highlight the need for comorbidity screening and novel prevention strategies for persons with HIV using across-the-lifespan approaches that are tailored by sex and gender. Characteristics and Outcomes of Pregnant Women With HIV Undergoing Tuberculosis Screening in Uganda Christina Yoon 1 , Lelia H. Chaisson 1 , Shafic Makumbi 2 , David W. Dowdy 3 , Patrick Phillips 1 , Henry Ssenyondo 4 , Suzanne Dufault 1 , Sylvia LaCourse 5 , Annettee Nakimuli 4 , Fred C. Semitala 4 1 University of California San Francisco, San Francisco, CA, USA, 2 Infectious Disease Research Collaboration, Kampala, Uganda, 3 The Johns Hopkins University School of Medicine, Baltimore, MD, USA, 4 Makerere University College of Health Sciences, Kampala, Uganda, 5 University of Washington, Seattle, WA, USA Background: Systematic screening for tuberculosis (TB) may be particularly important for pregnant women with HIV (PWWH), as pregnancy increases TB risk independent of HIV. However, little is known about PWWH undergoing TB screening. We describe characteristics and pregnancy outcomes of PWWH enrolled in an ongoing trial evaluating the impact of two WHO-approved TB screening strategies on prevalent TB detection and TB preventive therapy (TPT) uptake. Methods: From Nov 2020 to Jan 2023, we enrolled consecutive ART-naïve adults presenting to 4 HIV clinics in Uganda in a randomized trial comparing outcomes of different TB screening strategies (NCT04557176). All participants The figure, table, or graphic for this abstract has been removed.

Poster Abstracts

989

CROI 2025 313