CROI 2019 Abstract eBook

Abstract eBook

Poster Abstracts

Conclusion: Our results showed that PLWH experience earlier onset of non-HIV related comorbidities that can contribute to accelerated aging. The gaps in the prevalence of comorbidities could be related to HIV related inflammation, life-style issues and toxicities related to older ART. These results further stress the need for early HIV diagnosis and ART initiation with maintenance of long- term virologic suppression, as well as optimized general clinical screening for comorbidities at earlier age among PLWH.

to a similar extent in HIV+ women (from 30% [95%CI: 25%, 35%] at 1 year to 26% [95%CI: 21%, 31%] at 10 years after DM diagnosis) and HIV- women (from 25% [95%CI: 19%, 32%] at 1 year to 18% [95%CI: 13%, 24%] at 10 years after DM diagnosis; p=0.2902 for HIV status*time, see Figure). Conclusion: We noted large and growing gaps in DM care goal achievement in both HIV+ and HIV- women. Opportunities to improve DM care are numerous; aggressive DMmanagement interventions among HIV+ and HIV- women are needed.

Poster Abstracts

1069 TOTAL AND CENTRAL OBESITY PREDICT COGNITIVE DECLINE: MULTICENTER AIDS COHORT STUDY

1068 POOR DIABETES CONTROL IN HIV+ AND HIV- WOMEN: OPPORTUNITIES FOR INTERVENTION Karla I. Galaviz 1 , Jonathan Colasanti 1 , Cyra Christina Mehta 1 , Phyllis Tien 2 , Adaora Adimora 3 , Maria L. Alcaide 4 , Mardge H. Cohen 5 , Deborah Gustafson 6 , Roksana Karim 7 , Deborah Konkle-Parker 8 , Daniel Merenstein 9 , Anjali Sharma 10 , Michael F. Schneider 11 , Gina Wingood 12 , Igho Ofotokun 1 1 Emory University, Atlanta, GA, USA, 2 University of California San Francisco, San Francisco, CA, USA, 3 University of North Carolina at Chapel Hill, Chapel Hill, NC, USA, 4 University of Miami, Miami, FL, USA, 5 Rush University Medical Center, Chicago, IL, USA, 6 SUNY Downstate Medical Center, Brooklyn, NY, USA, 7 University of Southern California, Los Angeles, CA, USA, 8 University of Mississippi Medical Center, Jackson, MS, USA, 9 Georgetown University, Washington, DC, USA, 10 Albert Einstein College of Medicine, Bronx, NY, USA, 11 Johns Hopkins University, Baltimore, MD, USA, 12 Columbia University, New York, NY, USA Background: Type 2 diabetes mellitus (DM) is an increasingly common comorbidity among HIV+ populations. It remains unknown whether there are longitudinal differences in achievement of DM care goals between HIV+ and HIV- adults. We examined DM care goal achievement between HIV+ and HIV- women within 10 years of DM detection. Methods: We analyzed longitudinal data from the Women’s Interagency HIV Study. We identified women with incident DM defined as the first visit when women self-reported DMmedication use or had two fasting plasma glucose (FPG) measures ≥126 mg/dL, or Hemoglobin A1c (A1c) ≥6.5% plus a FPG ≥126 mg/dL. At 1, 3, 5, and 10 years after DM diagnosis, we estimated proportions of women who met the ABC DM treatment goals (glycated hemoglobin [A1c] <7.0%, blood pressure [BP] <140/90mmHg, LDL Cholesterol <100 mg/dL), by HIV status. Using generalized logistic mixed models, we estimated the probability of achieving ABC goals by HIV status controlling for age, race, body weight, DM, BP and Cholesterol medication use, time since DM diagnosis, and knowledge of DM diagnosis (i.e. self-reported DM diagnosis). Results: There were 390 HIV+ (mean age 46.4 years, SD 8.5) and 169 HIV- women (mean age 45.2 years, SD 9.5) with incident DM and at least one follow- up A1c measure. At baseline, 80% of HIV+ and 86% of HIV- women did not know they had DM. Crude proportions of HIV+/HIV- women using DM, BP and Cholesterol medications were 7%/6% at 1 year, 9%/17% at 3 years, 12%/13% at 5 years, and 28%/25% at 10 years after DM diagnosis. Crude proportions of HIV+/HIV- women achieving ABC treatment goals were 33%/31% at 1 year, 19%/34% at 3 years, 28%/24% at 5 years, and 27%/17% 10 years after DM diagnosis. Adjusted analyses showed ABC goal achievement worsened over time

Leah H. Rubin 1 , Deborah Gustafson 2 , Kellie L. Hawkins 3 , Long Zhang 1 , Lisa Jacobson 1 , James T. Becker 4 , Cynthia Munro 1 , Jordan E. Lake 5 , Eileen Martin 6 , Andrew Levine 7 , Todd T. Brown 1 , Ned Sacktor 1 , Kristine M. Erlandson 3 1 Johns Hopkins University, Baltimore, MD, USA, 2 SUNY Downstate Medical Center, Brooklyn, NY, USA, 3 University of Colorado, Aurora, CO, USA, 4 University of Pittsburgh, Pittsburgh, PA, USA, 5 University of Texas at Houston, Houston, TX, USA, 6 Rush University Medical Center, Chicago, IL, USA, 7 University of California Los Angeles, Los Angeles, CA, USA Background: Among adults with HIV infection, obesity may contribute to multisystem dysregulation including cognitive impairments. We examined body mass index (BMI) and central obesity (waist circumference, WC) in association with domain-specific cognitive function and 10-year cognitive decline in adult men living with HIV infection (HIV+) compared to at-risk men without HIV infection (HIV-). Methods: The longitudinal Multicenter AIDS Cohort Study (MACS) of HIV infection among HIV+men and at-risk controls (HIV-) provide data for these analyses. Inclusion criteria included: >40 years old at first neuropsychological testing; and for HIV+men, ≥2 antiretroviral agents and HIV-1 RNA <400 copies/mL at >80% of visits. Outcomes included neuropsychological test scores measured every 2 years. Tests included: learning (RAVLT total learning, Rey immediate recall), memory (RAVLT delayed recall, Rey delayed recall), executive function (TMT-Part B, Stroop interference trial), processing speed (SDMT, Stroop color-naming trial), sustained attention and working memory (CALCAP mean simple and complex reaction time), and fine motor function (GPEG-dominant and non-dominant hand). Exposures included baseline BMI and WC. Linear mixed effects models included all available visits from 1996-2015, adjusted for baseline sociodemographic, behavioral, and clinical characteristics, stratified by HIV-serostatus. Results: Among 972 (316 HIV+ and 656 HIV-) men at baseline, higher BMI (≥25 kg/m 2 ) was cross-sectionally associated with lower motor function in HIV+ and HIV-, and lower attention/working memory in HIV- men. Obese WC (≥102 cm, 40 inches) was associated with lower motor function in HIV+ and HIV- men. Longitudinal analyses (Fig 1) indicated that overweight (BMI 25.0-29.9 kg/m 2 ) or obese (BMI ≥30 kg/m 2 ) vs normal BMI (18.5 to 24.9 kg/m 2 ) was associated with less decline in motor function in HIV+men, but greater decline in motor function, memory, and learning in HIV- men. WC showed similar patterns. Conclusion: Higher BMI and central obesity are associated with lower cognitive performance cross-sectionally and greater cognitive decline, particularly in

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