CROI 2025 Abstract eBook

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Poster Abstracts

1174 WITHDRAWN

(aOR=1.14 [1.07, 1.21]) PWH compared with non-Hispanic white PWH. PWH reporting injection drug use (aOR=1.13 [1.04, 1.23]) or men who have sex with men (aOR=1.15 [1.07, 1.23]) had higher odds of viral blips than PWH reporting heterosexual HIV risks. The odds of a viral blip were higher among PWH with BMI >24.9 kg/m 2 : aOR=1.12 [1.07, 1.17] and lower among PWH with BMI <19 kg/m 2 ; aOR=0.60 [0.54, 0.67] compared with PWH with a BMI between 19-24.9 kg/m 2 measured at study completion. PWH with lower CD4 cell counts and higher HIV viral loads at the time of ART initiation had greater odds of a viral blip ( figure ). At study completion compared to PWH on non-nucleoside reverse transcriptase inhibitors (NNRTIs), those on integrase strand transfer inhibitors (INSTIs) had a reduced odds of blip, and those on protease inhibitors (PIs) had an increased odds of blip. Conclusions: Nearly 25% of PWH experienced a viral blip over the study period. Factors associated with viral blips included older age, race/ethnicity, BMI, HIV acquisition risk, CD4 count and ART regimen. Further studies are needed to identify if blips are associated with subsequent HIV virologic failure.

Poster Abstracts

1176 Time From HIV Infection to Diagnosis Using CD4 Depletion Model: Thailand, 2014-2021 Suchunya Aungkulanon 1 , Wolfgang Hladik 2 , Cheewanan Lertpiriyasuwat 3 , Anne Peruski 2 , Rommel Bain 2 , Ruiguang Song 2 , Poonchana Wareechai 4 , Sanny Northbrook 5 1 National Health Security Office, Chiang Mai, Thailand, 2 Centers for Disease Control and Prevention, Atlanta, GA, USA, 3 Ministry of Public Health, Nonthaburi, Thailand, 4 National Health Security Office, Bangkok, Thailand, 5 US Centers for Disease Control and Prevention Nonthaburi, Nonthaburi, Thailand Background: Timely diagnosis of HIV is crucial for effective treatment and prevention of transmission. In Thailand, despite advancements in HIV prevention and treatment, delays in diagnosis remain a significant challenge. We estimated delays in diagnosis (time from infection to diagnosis) and identified factors associated with the delay. Methods: Data on newly reported treatment-naïve people living with HIV (PLHIV) ≥13 years diagnosed at 1,084 health units during 2014–2021 were obtained from Thailand’s National AIDS Program. We used CD4 depletion model to estimate the infection date using model parameters originally derived from the Concerted Action of Seroconversion to AIDS and Death in Europe Study (CASCADE) adjusted using published parameters from Asian population samples to account for differences in the rate of CD4 decline across HIV subtypes. We estimated time from infection to diagnosis by calculating the time difference between infection and diagnosis. We abstracted data on demographics, self-reported risk behaviors, dates of HIV testing, and dates and results of CD4 testing from HIV records. Multivariable linear regression analysis was used to identify factors influencing time from infection to diagnosis. Results: Of 242,338 PLHIV, 201,752 (83.3%) had a baseline CD4 test within 6 months after diagnosis. Among those with baseline CD4 data, the median baseline CD4 count was 187 cells per µL (IQR 51–383). We estimate that among PLHIV diagnosed in 2021, the average time from infection to diagnosis was 5.7 years, 27% of them being diagnosed within a year of infection. The average delay in diagnosis in 2021 varied by age and population group with longer delays seen among 25–34-year-olds (6.2 years), 35-44-year-olds (6.7 years), men who inject drugs (9.4 years), and heterosexual men (6.6 years). The average

1175 Prevalence and Risk Factors of HIV Viral Blips in the NA-ACCORD, 2010-2020 Raynell Lang 1 , Morris Chan 2 , Jintong Yan 3 , Michael Horberg 3 , Jennifer O. Lam 4 , Vincent C. Marconi 5 , Keri N. Althoff 6 , Joseph J. Eron 7 , Kelly Gebo 8 , M. John Gill 1 , Maile Karris 9 , Mona Loutfy 10 , Haidong Lu 11 , Richard Moore 6 , Viviane D. Lima 2 , for the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) of IeDEA 1 University of Calgary, Calgary, Canada, 2 British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada, 3 Kaiser Permanente Mid-Atlantic States, Rockville, MD, USA, 4 Kaiser Permanente Northern California, Oakland, CA, USA, 5 Emory University, Atlanta, GA, USA, 6 The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA, 7 University of North Carolina at Chapel Hill, Chapel Hill, NC, USA, 8 The Johns Hopkins University School of Medicine, Baltimore, MD, USA, 9 University of California San Diego Medical Center, La Jolla, CA, USA, 10 Women's College Research Institute, Toronto, Canada, 11 Yale University, New Haven, CT, USA Background: HIV viral blips defined as a viral load between 51-999 copies/ mL (preceded and followed by <50 cp/mL at least 1 to 12 months apart) occur among people with HIV (PWH) despite effective antiretroviral therapy (ART). Within the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD), we aimed to describe the prevalence and risk factors associated with experiencing at least one viral blip. Methods: US and Canadian PWH 18 years or older in the NA-ACCORD were followed from the first suppressed viral load (<50 cp/mL) measured >12 months after ART initiation or 1/1/2010 until the earliest of viral blip (event), the last visit prior to a gap of >2 years without a CD4 or viral load (loss to follow-up), death or 12/31/2020. Logistic regression models estimated crude and adjusted odds ratios (aOR) and 95% confidence intervals to identify factors associated with experiencing a viral blip (see Figure for co-variates included in models). Results: Among 77,670 PWH, 18,327 (24%) experienced a viral blip during the study period. Older age was associated with increased odds of viral blip (per 10-year increase in age: aOR=1.05 [1.03, 1.07]). The odds of a viral blip were higher among non-Hispanic Black (aOR=1.12 [1.07, 1.17]) and Hispanic

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