CROI 2016 Abstract eBook

Abstract Listing

Poster Abstracts

detects 20 antiretroviral (ARV) drugs. Individuals who had two or more detectable ARVs consistent with a known drug regimen were considered to be using ART, and individuals with a plasma HIV viral load <400 copies/ml were considered virologically suppressed. Associations between demographic and behavioral factors and inaccurate self-reported ART use were estimated as adjusted prevalence risk ratios (adjPRR) using modified multivariable Poisson regression. Results: There were 153 (27%) participants who self-reported ART use and of these individuals 148 (97%) had detectable ARVs included in common ART regimens in Uganda. We also detected ARVs in 11% (n=46/405) of individuals who did not self-report ART use. Overall the specificity of self-reported ART use was 99% and the sensitivity was 76%. Positive and negative predictive values were 96.7% and 89.1%, respectively. Underreporting of ART use decreased with older age (adjPRR=0.96; 95%CI: 0.92-1.00) and was higher with trading occupations (adjPRR=2.81; 95%CI: 1.17-7.48), but not with residence in a fishing community. Among 284 individuals with HIV plasma viral load data, 12% (n=10/81) of individuals with two or more ARVs had a detectable HIV viral load compared to 85% (n=173/213) of those who had one or no ARVs detected. Among those with detectable ARVs, levels of viral suppression were similar irrespective of self-reported ART use. Conclusions: Individuals who self-report ART use are most likely to be using ART; however, there is under-reporting of ART use among younger persons and those involved in trading. Further research on barriers to self-reported ART use, the source of these drugs, and the potential for ART drug resistance is critically needed in African populations. 955 Hospital-Based ART Delivery and Patient Outcomes: A Prospective Open Cohort in China Chuanyi Ning 1 ; M. Kumi Smith 2 ;Yufeng Hu 3 ;Yun Lan 3 ; Joseph D.Tucker 1 ;Weiping Cai 3 1 Univ of North Carolina at Chapel Hill Inst for Global Hlth & Infectious Diseases, Chapel Hill, NC, USA; 2 Johns Hopkins Bloomberg Sch of PH, Baltimore, MD, USA; 3 Guangzhou Eighth People’s Hosp, Guangzhou, China Background: Enormous efforts have been made to develop the capability of treating large numbers of people across wide geographic areas, increased link to care in Center for Disease Control or developed thousands of countryside hospitals network spread all over China in every village. To obtain insights into the long-term outcome of hospital based ART delivery system in China. We report 10-year sentinel hospital-based outcomes of combined ART in HIV/AIDS in Guangdong Province of China. Methods: Post-hoc analysis of a prospectively open cohort from collected, observational database from Guangdong. All patients in the outpatient health care facilities providing HIV medical care from Jan 2004 to June 2014. Patients were excluded if they had not started triple therapy, had missing treatment regimen information, or used ART outside of national guidelines. Mortality rate and survivor rate, according to World Health Organization criteria were calculated. Data were used to homochromous compare to previous published mortality and survivor rates of national cART program in 2004-2008. Results: Of 18,921 infections, 16,757 (88.6%) were link to care in 24 HIV/AIDS sentinel hospitals, among 14,885 were initialed cART were included in analysis. Mean age were 38.6 years, 73.2%were men, 55.5%were infected through heterosexual transmission, and 17.9%were injection drug use and 19.0%were man sex with man. Mortality was greatest during the first three months of treatment (15.9 deaths per 100 person-years) but decreased to a steady average rate of 3.1 deaths per 100 person-years after 6 months. The average median baseline CD4 was 164 cells/ml and increased to 204 cells/ml in 2014 in hospital. In an adjusted Cox regression analysis, the strongest risk factors for death were having a low CD4 and multiple baseline symptom categories at treatment initiation. Those with CD4 less than 50 cells/ml had an adjusted HR of 6.3 (95% CI, 2.2 to 20.0) compared with those with CD4 cell counts of 350 cells/ml or greater.The average virological suppressive rate was 92% from 2005-2014. National ART programmortalities were significant difference in 3-4 folds than hospital based ART delivery system in Guangdong 2004-2008, P<0.05 (Figure 1). Conclusions: The hospital-based Guangdong model of HIV service delivery was associated more access to medical and better outcomes. Scaled up hospital model can continence enhance follow-up management on infected persons and patients expand treatment coverage and improve nadir CD4 on baseline. 0.98 0.96 0.95 0.94 0.93 0.92 0.91 0.89 0.88 0.87 0.86 0.85 0.84 0.83 0.82 0.8 0.79 0.79 0.79 0.79 1.00 0.94 0.92 0.91 0.9 0.89 0.88 0.87 0.86 0.85 0.84 0.83 0.82 0.82 0.81 0.8 0.79 0.78 0.78 0.77 0.76 22.6 25.0 1.00

0.80

20.0

Survival rate of Guangdong Survival rate of Na=onal

0.60

15.0

Deaths per 100 person-­‐year of na=onal Deaths per 100 person-­‐year of Guangdong

9.4

Poster Abstracts

0.40

10.0

7.3

5.5 4.9 4.7 4.3 4.5 4.7

4.0 4.0 3.9 4.3 3.9 4.4 4.8 4.2 3.9 4.2 4.8 5.0

5.0

0.20

1.9

2.3

2.3 1.3 1.4 0.9 1.2 1.0 1.1

2.1 1.1 1.3 1.4 1.4

0.8

0.6

0.9

0.0 0.0

0.0

0.00

2004.00 2004.03 2004.06 2004.09 2004.12 2005.03 2005.06 2005.09 2005.12 2006.03 2006.06 2006.09 2006.12 2007.03 2007.06 2007.09 2007.12 2008.03 2008.06 2008.09 2008.12

Compare to HAART in Guangdong Province and na;onal among 2004-­‐2008

Guangdong survival table per 3-month interval among 2004-2008 Entered

2372 1991 1727 1511 1324 1113 956

826

691

572

468

389

331

285

242

193

154

111

68

34

Censored

331

240

193

174

196

147

120

119

112

97

73

53

44

38

47

35

42

43

34

34

Death

173 50 24 23 13

15

10

10

16

7

7

6

5

2

5

2

4

1

0

0

National survival table per 3-month interval among 2004-2008 Entered

48785 3 9403 3 5378 3 2227 2 9175 2 6278 2 3891 2 1805 1 9802 1 7789 1 6136 1 4351 1 2693 1 0810 9 294

7763 5 394 4 119 3 020

2178

Censored

6 887 3150 2684 2677 2570 2118 1832 1760 1824 1483 1635 1513 1768 1406 1932 1803 1229 1062 811 957 Death 2495 875 467 375 327 269 254 243 189 170 150 145 115 110 99 66 46 37 31 21

405

CROI 2016