CROI 2016 Abstract eBook

Abstract Listing

Poster Abstracts

944 CD4 Cell Response to First-Line cART by HIV Type in European Cohort Collaborations LindaWittkop 1 ; Sophie Matheron 2 ; for the COHERE in EuroCoord and ACHIeV2e StudyTeamwriting committee 1 CHU de Bordeaux, Bordeaux, France; 2 Hosp Bichat-Claude Bernard, Paris, France

Background: CD4 cell recovery following first line combination antiretroviral treatment (cART) is known to be poorer in HIV-2 than in HIV-1 infected patients (Matheron et al AIDS 2006; Drylewicz et al AIDS 2008) but has not been studied yet in large datasets while adjusting for plasma viral load (pVL) and other characteristics at cART initiation. Methods: Adult patients from two European multi-cohort collaborations, COHERE (HIV-1) and ACHIeV2e (HIV-2) were included, if they were treatment-naïve and started first line cART (NNRTI-containing regimens excluded) from 1997 to 2011, had ≥1 CD4 cell measure before and after start of cART, and a pretreatment pVL. Evolution of CD4 cell count was studied using linear mixed models adjusting for pre-treatment pVL, age, sex, geographic origin, HIV transmission route, previous AIDS diagnosis, cART regimen, period of cART initiation, and pre-treatment CD4 cell counts. We did several sensitivity analyses considering pVL as a binary variable (with different cut-offs), as a continuous and as a time dependent covariable. Results: We included 159 HIV-2 and 42,735 HIV-1 infected patients with a median age of 46 (IQR): 36; 52) and 37 (IQR: 32; 44) years, respectively. Median pre-treatment CD4 cell counts/mm 3 were 182 (IQR: 83-285) and 224 (IQR: 100-352) in HIV-2 and HIV-1 infected patients, respectively. The median observed CD4 cell counts at 12 months were 276 (171; 416) in HIV-2 and 382 (244; 550) in HIV-1 infected patients. Adjusted estimated mean CD4 cell increases within the first year of cART were overall significantly lower in HIV-2 compared to HIV-1 infected patients: 31 CD4 cells/mm 3 /12 months less (95% CI: 12; 51; P = 0.002). In sensitivity analyses (Figure) similar differences between HIV-2 and HIV-1 have been found. In stratified analysis, differences in CD4 cell increases for HIV type were not modified by the initial cART regimen (interaction test: P =0.93). Patients receiving a boosted lopinavir or darunavir containing cART HIV-2 infected patients had a slower CD4 cell increase than HIV-1 infected patients (33 cells/mm 3 /12 months less (95% CI: 3-62; P =0.03)). Conclusions: Poorer CD4 cell increase following first-line cART in HIV-2 infected patients was consistent in all analyses and independent of pre-treatment pVL, as well as of age, cART regimen and other covariables adjusted for. Our results are in favour of early treatment of HIV-2 infection and the need to identify the most potent drugs against HIV-2.

Poster Abstracts

945 Efficiency (Cost-Effectiveness) of EFV/FTC/TDF vs FTC/RPV/TDF in Naïve Patients Jose M. Gatell 1 ; Elisa de Lazzari 2 ; Enrique Redondo 3 ; Jose Mallolas 2 ; Esteban Martinez 2 ; Jordi Blanch 2 ; Maria Martinez-Rebollar 2 ; Jose L. Blanco 2 ; BertaTorres 2 1 Hosp Clinic of Barcelona, Barcelona, Spain; 2 Hosp Clínic de Barcelona, Barcelona, Spain; 3 Gilead Scis, Inc, Madrid, Spain Background: FTC/RPV/TDF (EPA) has advantages compared with EFV/FTC/TDF (ATR) in patients with baseline viral load of less than 10 5 copies/ml. Yet, a formal cost-effectiveness (efficiency) analysis had not been performed so far. Methods: All HIV antiretroviral naïve patients of a single center who initiated ATR or EPA and with a minimum of 48 weeks potential follow-up were eligible and followed up to censoring date (Dec 2014). Data were prospectively collected in a predefined database. Effectiveness was measured as percentage of patients < 50 copies/ml. at 48 weeks by ITT

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CROI 2016