CROI 2025 Abstract eBook

Abstract eBook

Poster Abstracts

At multivariate regression (table 1), the risk of clearance of ≥1 HPV genotype included in the 9-valent vaccine was lower in younger (<35 years) people. Conclusions: These results emphasize the importance of age in virus clearance among immunized individuals. We endorse consensus guidelines recommending anal cancer screening start at age 35 for MSM with HIV, as viral persistence is more likely in this group.

and treatment for CT/NG and were offered oral PrEP at enrolment and follow-up visits. We compared pregnancy loss (miscarriage [<20 weeks] or stillbirth [>20 weeks]) and birth outcomes (low birthweight (LBW) [<2500grams], preterm delivery (PTD) [<37weeks], small for gestational age (SGA) [<10th percentile] and neonatal death [<7days]) among women diagnosed with or without CT/ NG at study enrolment. Logistic regression models assessed the association between STI diagnosis, time to treatment and adverse pregnancy outcomes adjusting for maternal age, relationship status, gravidity and gestational age. Results: Among 1261 pregnant women, 28% had CT/NG at enrolment (24% for CT and 8% for NG). Of those with CT/NG (n=353), 54% received immediate treatment, 34% delayed treatment (median time to treatment 28 days; IQR: 15-57 days) and 12% were not treated during pregnancy. Of 1244 women with singleton pregnancies, outcomes were: 42 (3%) miscarriage, 31 (2%) stillbirth and 1171 (93%) live births (including 72 (6%) preterm and 50 (5%) low birthweight). Proportions of miscarriage and stillbirth were highest in women with untreated CT/NG (12% and 9%), lower in women with CT/NG and delayed treatment (4% and 3%), and lowest among women with CT/NG and immediate treatment (1% and 2%). In women with CT/NG, untreated STI was associated with increased odds of pregnancy loss (aOR=3.89, 95% CI: 1.51-9.97) compared to STI with immediate treatment. In all women, untreated CT/NG was associated with increased odds of pregnancy loss (aOR=4.27, 95% CI: 1.95-9.34) compared to no STI. Conclusions: Pregnant women without HIV in a PrEP cohort study diagnosed with CT/NG (POC or laboratory) and remained untreated during pregnancy had higher odds of miscarriage or stillbirth compared to those without STI or who received immediate treatment. Our results suggest important benefits of POC screening and immediate treatment of curable STIs in pregnancy in improving outcomes. The figure, table, or graphic for this abstract has been removed. 1266 High Incidence of Curable Sexually Transmitted Infections in HPTN 084: A Tertiary Analysis Harriet Nuwagaba-Biribonwoha 1 , Brett S. Hanscom 2 , Daniel Haines 2 , Yaw O. Agyei 3 , Joseph Makhema 4 , Juliet Mpendo 5 , Nyaradzo Mgodi 6 , Victor Mudhune 7 , Jennifer Farrior 8 , Lydia Soto-Torres 9 , James F. Rooney 10 , Alex Rinehart 11 , Mina Hosseinipour 12 , Sinead Delany-Moretlwe 13 , for the HPTN 084 Study Team 1 ICAP at Columbia University, New York, NY, USA, 2 Fred Hutchinson Cancer Center, Seattle, WA, USA, 3 The Johns Hopkins University School of Medicine, Baltimore, MD, USA, 4 Botswana Harvard AIDS Institute Partnership, Gabarone, Botswana, 5 Uganda Virus Research Institute-International AIDS Vaccine Initiative, Entebbe, Uganda, 6 University of Zimbabwe Clinical Trials Research Centre, Harare, Zimbabwe, 7 KEMRI CGHR, Kisumu, Kenya, 8 FHI 360, Durham, NC, USA, 9 Division of AIDS, Bethesda, MD, USA, 10 Gilead Sciences, Inc, Foster City, CA, USA, 11 ViiV Healthcare, Durham, NC, USA, 12 University of North Carolina Project–Malawi, Lilongwe, Malawi, 13 University of the Witwatersrand, Johannesburg, South Africa Background: Sexually transmitted infections (STIs) can signal ongoing risk of HIV acquisition and have adverse reproductive health sequalae. We assessed STI disease burden among women participating in the HPTN 084 trial during the blinded and unblinded period. Methods: HIV uninfected women ages 18-45 years (y) in the HPTN 084 study were tested and treated for syphilis, Chlamydia trachomatis (CT), Neisseria gonorrhoea (NG) and Trichomonas vaginalis (TV) at baseline and every 6 months. We assessed baseline STI prevalence, post-baseline STI incidence rates; STI recurrence (≥2 episodes of CT, NG or TV >5 months apart), and concurrent STIs (≥2 STIs diagnosed within 7 days). Correlates of incident STIs were estimated using multiple regression. Cabotegravir (CAB) PrEP efficacy in the blinded study period was compared for people with and without STIs using Cox regression. Results: Of 3224 women enrolled (median age 25y), 30.1% (95% CI 28.6%, 31.7%) had an STI at baseline. Among 2983(92.5%) women with follow-up data, 3111 incident STIs occurred over 7124 person years (PY), incidence rate (IR) 43.7 events/100PY [95% CI 42.2, 45.2]); most commonly CT (Table 1). STI IRs ranged from 18.5/100PY in Kenya to 49.4/100PY in Eswatini. Concurrent STIs were observed among 6.1% (95% CI 5.30%, 7.06%) of women at baseline and 14.4% (95% CI 13.1%, 15.7%) during follow-up; CT and NG were the most common concurrent infections. Of the 2983 women with follow-up data, 841(27.3%) had STI recurrence. In multivariable analyses, STIs incidence was significantly higher among women18-24y vs women ≥25y (Relative Risk [RR] 1.52, 95% CI 1.40, 1.66); among single women (RR 1.79 95% CI 1.55, 2.08), women not living with partners (RR 1.66 95% CI 1.44, 1.92) vs women married/living as married; and

1264 Sustained HIV Viral Suppression as a Predictor of High-Risk Human Papillomavirus Infection Douglas Gaitho, Silvia Kadima, Isaac Kirui, Daniel Kiptum, Sylvester Kimaiyo Academic Model Providing Access to Healthcare, Eldoret, Kenya Background: HIV infection is associated with an increased risk of human papillomavirus (HPV) acquisition, decreased clearance of HPV, and increased risk of precancerous lesions and cervical cancer. Despite the availability of antiretroviral therapy (ART), there is paucity of data describing the association between sustained HIV viral suppression and HPV infection. Achieving durable HIV viral suppression could be a potential strategy for mitigating adverse outcomes associated with high-risk HPV infections. Methods: We conducted retrospective data analysis and included all WLHV who had received cervical cancer screening using HPV typing as part of a pilot between June and September 2024 within an extensive HIV program in Western Kenya. Deidentified data were abstracted from electronic medical records, including age, nadir CD4 count and ART duration, identified a priori as potential confounders. Sustained viral suppression, defined as an undetectable viral load of fewer than 50 copies per millimetre from ART initiation, was our exposure of interest. Our outcome was defined as the presence of high-risk HPV serotypes from self-collected cervical samples. Log binomial regression was used to estimate the odds of high-risk HPV infection by sustained viral suppression. Results: Overall, we included 795 WLHIV, of whom 323 (40.6%) had sustained viral suppression, whereas 472 (59.4%) had periods of non-suppression from the time of ART initiation. The age and duration of ART did not differ based on viral suppression, with a median of 41 years (IQR 36-46) and 9.1 years (IQR 4.8-14.8), respectively. WLHV with a nadir CD4 count of less than 200 cells per millimetre was 36 (11.1%) among those with sustained HIV viral suppression and 40 (8.5%) among those with periods of being unsuppressed. The prevalence of high-risk HPV infection was 40.7% and 42.3% when comparing those with sustained HIV viral suppression versus those who did not, respectively. WLHIV who did not have sustained HIV viral suppression had 1.5 times higher odds of having high risk HPV infection (aOR=1.5, 95% CI, 1.3-1.6, p-value < 0.001). Conclusions: The odds of high-risk HPV infection were higher among WLHV who had periods of HIV non-suppression after adjusting for nadir CD4, duration on ART and age. 1265 Diagnostic Screening and Treatment of Curable STIs in Pregnancy and Impact on Pregnancy Outcomes Dorothy C. Nyemba 1 , Alex de Voux 2 , Rufaro Mvududu 2 , Remco Peters 3 , Sinead Delany-Moretlwe 1 , Leigh F. Johnson 2 , Thomas Coates 4 , Landon Myer 2 , Dvora L. Joseph Davey 4 1 University of the Witwatersrand, Johannesburg, South Africa, 2 University of Cape Town, Cape Town, South Africa, 3 World Health Organization, Geneva, Switzerland, 4 University of California Los Angeles, Los Angeles, CA, USA Background: Sexually transmitted infections (STIs) during pregnancy are associated with adverse pregnancy outcomes. We evaluated the impact of diagnosing and treating curable STIs (Chlamydia [CT]/Gonorrhoea [NG]) during pregnancy on adverse pregnancy outcomes among women in a HIV pre exposure prophylaxis (PrEP) cohort study in Cape Town, South Africa. Methods: Eligible women >16 years, attending antenatal care, without HIV, received HIV prevention counselling, diagnostic testing with Gene-Xpert (point-of-care (POC)) ( Aug 2019-Nov 2020 ) or laboratory ( Dec 2020-Oct 2021 )

Poster Abstracts

CROI 2025 418