CROI 2019 Abstract eBook

Abstract eBook

Poster Abstracts

examining health outcomes and service use of PLWHIV and a 10% sample of HIV-negative individuals in BC. Wrist, humerus, vertebrae and hip fractures were considered as ORF and were assessed using physician and hospital-based administrative data and ICD-9/10. The effect of the variables on the risk of ORF was assessed by logistic generalized estimating equation model. Sex, age at ART initiation, previous injuries, history of injection drug use (IDU), ART initiation era and viral suppression were covariates. The effect of ART drug classes was analyzed in a univariate model including data after ART initiation. TDF was studied separately and considered only data after TDF was available in BC. Results: A total of 6,846 PLWHIV and 514,619 HIV negative individuals were included in the incidence analysis. ORF occurred in 416 PLWHIV and 28,028 HIV-negative individuals (6.08% versus 5.45% p=0.02). Among PLWHIV, 63% of the first ORF occurred before the age of 50 years of age, while only 34% occurred before age 50 in the HIV negative group (p<.0001). In a multivariate analysis, female sex, older age at ART initiation, IDU and previous injuries were associated with increased risk of ORF; while later ART initiation era and higher proportion of viral suppression were associated with reduced likelihood of ORF. ART drug classes and TDF were negatively associated with having an ORF. (Table 1). Conclusion: Higher incidence of ORF was found in PLWHIV versus HIV negative individuals at an earlier age. In our population, viral suppression and length of time on ART were associated with reduced risk of ORF, including ART regimes containing TDF, which in previous studies have been shown to be associated with bone toxicity. Our study indicates that early initiation of ART may reduce the risk for ORF in PLWHIV.

1 Hospital General Universitario Gregorio Marañón, Madrid, Spain, 2 La Paz University Hospital, Madrid, Spain, 3 Hospital Sant Pau, Barcelona, Spain, 4 Hospital Universitario de la Vall d’Hebron, Barcelona, Spain, 5 Hospital Donostia, San Sebastián, Spain, 6 Hospital Universitario Clínico San Carlos, Madrid, Spain, 7 Hospital Ramón y Cajal, Madrid, Spain, 8 Hospital Universitario de La Princesa, Madrid, Spain, 9 Hospital Universitario Príncipe de Asturias, Madrid, Spain, 10 Hospital Clinic of Valencia, Valencia, Spain, 11 Hospital Universitario San Cecilio, Granada, Spain, 12 University Hospital Gregorio Marañon, Madrid, Spain Background: HCV infection has been associated with increased risk of bone loss and fracture in HIV-infected persons. Little is known, however, about the effects of eradication of HCV on bone mineral density (BMD) in HIV/HCV- coinfected persons. Methods: We performed a multicenter prospective study (Feb 2012 to Mar 2014) to analyze BMD at baseline and 96 wk after initiation of anti-HCV Rx in HIV/HCV-coinfected persons. BMD was assessed by dual-energy X-ray absorptiometry (DXA) at the lumbar spine and femoral neck. Definitions: osteoporosis, T score, ≤−2.5 SD; osteopenia, T score, −1 to −2.5 SD. As different densitometers were used, standardized BMD (sBMD) was calculated using published equations for the femoral neck (J Bone Mineral Research 1997;12:1463) and lumbar spine (Osteoporosis International 2001;12:438). Results: Paired determinations of BMD were made in 160 patients in 13 centers using Hologic® (n=113), Lunar® (n=30), and Norland® (n=17). Median age was 49 y. Men accounted for 74.4%, and prior IDU for 73.8%. Cirrhosis was detected in 46.3%, smokers accounted for 68.1%, and 2.5% of patients had a high alcohol intake. Anti-HCV Rx included pegylated interferon + ribavirin (PR) in 35%, PR + a first-generation HCV protease inhibitor in 44%, sofosbuvir + R in 12.5%, and PR + daclatasvir in 8.1%. A total of 102 patients (64%) achieved a sustained viral response (SVR). Statistically significant differences between responders and nonresponders were found in baseline HCV-RNA and type of anti-HCV Rx. At baseline, sBMD values (g/cm2) were similar between responders and nonresponders in the lumbar spine (median [95%CI] 1.02 [0.89-1.14] vs 1.00 [0.92-1.11], P=0.739); however, a trend towards higher sBMD was found in the femoral neck in responders compared with nonresponders (median [95% CI] 0.85 [0.75-0.94] vs 0.78 [0.72-0.87], P=0.06). No differences in sBMD changes from baseline to wk 96 were found between responders and nonresponders in the lumbar spine (median [95% CI] –0.01 [–0.03 to 0.03] vs –0.01 [–0.03 to 0.03], P=0.76) or femoral neck (median [95% CI] –0.02 [–0.06 to 0.01] vs –0.02 [–0.05 to 0.01], P=0.97). No statistically significant differences were found in the proportion of patients with changes in the BMD categories (normal, osteopenia, osteoporosis) from baseline to week 96 at the lumbar spine or femoral neck (Table). Conclusion: Our data suggest that, in the medium term, eradication of HCV following anti-HCV Rx in coinfected patients is not associated with significant changes in BMD.

Poster Abstracts

688 HIV-ASSOCIATED HYPOPARATHYROIDISM: RESULTS FROM A GERMAN HIV COHORT Sebastian Noe 1 , Celia Oldenbuettel 1 , Silke Heldwein 1 , Carmen Wiese 1 , Ariane von Krosigk 1 , Farhad Schabaz 1 , Rita Pascucci 1 , Hans Jaeger 1 , Eva Wolf 2 , for the ArcHIV Study Group 1 MVZ Karlsplatz HIV Research and Clinical Care Center, Munich, Germany, 2 MUC Research, Munich, Germany Background: Parathyroid hormone (PTH) secretion in response to hypocalcemia was reported to be blunted in individual people living with HIV (PLWH). HIV-infection has therefore been acknowledged to be an infrequent cause of hypoparathyroidism (hypoPT). Population data are, however, missing. We evaluated the prevalence and characteristics of hypoPT in PLWH in a single- center cohort in Munich, Methods: Single-center substudy of the German multi-center ArcHIV Cohort Study. PLWH with available measurements of PTH and calcium levels in two

687 EFFECTS OF ERADICATION OF HCV ON BONE MINERAL DENSITY IN HIV/ HCV-COINFECTED PATIENTS Ana Carrero 1 , Juan Berenguer 1 , Victor Hontanon 2 , Josep M. Guardiola 3 , Jordi Navarro 4 , Miguel A. Von Wichmann 5 , Maria Jesus Tellez Molina 6 , Carmen Quereda 7 , Ignacio Santos 8 , José Sanz 9 , Maria J. Galindo 10 , José Hernández- Quero 11 , Juan Carlos López-Bernaldo 1 , José M. Bellón 12 , Juan González-García 2

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