CROI 2025 Abstract eBook

Abstract eBook

Poster Abstracts

min/1.73m 2 ; p<0.001). The eGFR according to cystatin C was comparable in both groups (114.2 ml/min/1.73;m 2 vs 116.5ml/min/1.73m 2 ; p=0.15). The proportion of participants with ACR>30mg/g and proteinuria were comparable by treatment regimen (9.6% vs 13.0% p=0.30; 28.3% vs 30.2%, p=0.70). Conclusions: Abnormal ACR and proteinuria are prevalent among YPLHIV in Kampala, Uganda, and similar by ART regimen. While kidney function was largely within normal limits except creatinine which was higher among those on TDF/DTG, these findings raise concern. Longer-term follow-up is needed to understand whether YPLHIV on ART will develop chronic kidney disease as they age, and to elucidate risk factors for kidney disease progression that may be modifiable. 1067 Long-Term Immune Response to Vaccines in Vertically Infected People Living With HIV Annachiara Zin 1 , Elisa Barbieri 1 , Giulia Brigadoi 1 , Andrea Berlese 1 , Lorenzo Chiusaroli 1 , Daniele Mengato 2 , Andrea Francavilla 1 , Carlo Giaquinto 1 , Daniele Donà 1 , Osvalda Rampon 2 1 University of Padova, Padova, Italy, 2 Azienda Ospedaliera di Padova, Padua, Italy Background: Despite successful antiretroviral therapy (ART), people living with HIV (PLHIV) are at risk of suboptimal vaccine response, exposing this responses to vaccination in a cohort of PLHIV with vertically acquired infection. Seroprotection rates for diphtheria, tetanus, measles, mumps, rubella, varicella, and hepatitis B (HBV) were assessed at predefined intervals following primary immunization and at the most recent follow-up visit up to October 31, 2023, through a review of serological analyses and available medical records. Associations between vaccine responses and predictive factors were examined. Results: Eighty-five vertically infected PLHIV were included in the study, with a median age of 24 years(IQR 16–31 years). Before starting ART, 38% were at CDC stage 1, 24% at stage 2, and 38% at stage 3. In 2023, these percentages were 36%, 24%, and 40%, respectively. Only 27% began ART within their first year of life, with a median age of 53 months at initiation (IQR 12–118 months). By 2023, all patients were on ART, with 92% achieving undetectable viral loads. Two years after the last vaccine dose, seroprotection rates were 71% for diphtheria, 79% for tetanus and measles, 67% for mumps, 87% for rubella, and 54% for varicella. After five years, 50-70% retained protective antibodies, dropping to 50-58% after ten years, and below 30% after twenty years for most vaccines, except rubella (47%). Protection rates for HBV were the lowest, with only 60%, 37%, 24%, and 7.5% retaining protection after 2, 5, 10, and 20 years (Figure 1). In 2023, considering the most recent serologies available, seroprotection rates among PLHIV were 37% for diphtheria, 61% for tetanus, 46% for measles, and 25% for HBV. On multivariate analysis comparing seroprotected with non-seroprotected PLHIV (considering factors such as starting ART before 12 months of age, current CDC stage 3, CD4 count at the last vaccination dose, years since the last vaccination dose, complete vaccination schedule, and sex), only the years since the last vaccination dose correlated with vaccine response for all vaccinations. Conclusions: In this cohort of vertically infected PLHIV, seroprotection following vaccinations was lower and less durable compared to the general population. Thus, strict adherence to vaccination schedules and regular serological monitoring are essential for effective management of this population. vulnerable population to common vaccine-preventable diseases. Methods: This cross-sectional observational study evaluated humoral

Poster Abstracts

1066 Kidney Dysfunction in Young People Living With HIV on Dolutegravir Based Regimens in Kampala, Uganda Esther M. Nasuuna 1 , Robert Kalyesubula 2 , Risa Hoffman 3 , Chido Dziva Chikwari 4 , Helen A. Weiss 5 1 Infectious Diseases Institute, Kampala, Uganda, 2 Makerere University College of Health Sciences, Kampala, Uganda, 3 University of California Los Angeles, Los Angeles, CA, USA, 4 Biomedical Research and Training Institute, Harare, Zimbabwe, 5 London School of Hygiene & Tropical Medicine, London, UK Background: Young people living with HIV (YPLHIV) are at increased risk of developing kidney abnormalities due to antiretroviral therapy (ART), particularly tenofovir disoproxil fumarate (TDF). Dolutegravir (DTG) is associated with increased creatinine levels. We explored the association of dolutegravir ART regimens with kidney abnormalities among YPLHIV in Kampala, Uganda. Methods: We performed a cross-sectional study with YPLHIV aged 10-24 years in seven HIV clinics in Kampala. We collected a single urine and blood sample and measured the albumin creatinine ratio (ACR), proteinuria on dipstick, and estimated glomerular filtration rate (eGFR) using CKDEPI2021 equation (for ≥18 years) or bedside Schwartz (<18 years). Chi-square tests were used to compare kidney function parameters of those on TDF/DTG vs DTG combined with either zidovudine or abacavir (other regimens). Results: A total of 483 participants were enrolled, of whom 58% were female and 69% were aged 10-17 years. The median duration on ART was 9.6 years (IQR 8,12). Among the 357 (78%) participants on both TDF and TDG, the mean BMI was higher than those on other regimens (20.7 vs 18.7; p<0.001) as was mid upper arm circumference (25.5 vs 22.5;p <0.001) and mean serum creatine (0.67 vs 0.59; p<0.001). The mean cystatin C level was normal and comparable in both groups. The mean eGFR was within normal limits and lower among those on TDF/DTG compared to those on other regimens (132.3ml/min/1.73m 2 vs 142.1ml/

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