CROI 2016 Abstract eBook

Abstract Listing

Poster Abstracts

958 Response to ART and Mortality in Older HIV Patients in a Latin American Cohort Gabriela Carriquiry 1 ; Mark Giganti 2 ; Bryan E. Shepherd 3 ; Catherine C. McGowan 2 ; Eduardo Gotuzzo 1 1 Inst de Medicina Trop Alexander von Humboldt, Lima, Peru; 2 Vanderbilt Univ Sch of Med, Nashville, TN, USA; 3 Vanderbilt Inst for Global Hlth, Nashville, TN, USA Background: With successful highly active antiretroviral therapy (ART), HIV-infected persons are living longer. As these patients age, it is unclear whether comorbidities and their associated therapies, or the aging process itself, alter the response to cART. In this study, we compare HIV treatment outcomes and corresponding risk factors in older ART-treated patients relative to younger patients using data from the Caribbean, Central, and South America Network for HIV Epidemiology (CCASAnet).

Methods: HIV-positive adults (≥ 18 years) initiating ART at 7 sites in Argentina, Brazil, Chile, Haiti, Honduras, Mexico, and Peru were included. Patients were classified as older (≥ 50 years) or younger (< 50 years) based on age at ART initiation. ART effectiveness was measured using three outcomes: death, virologic failure, and ART regimen modification. Cox regression models for each outcome compared risk between older and younger patients, adjusting for other covariates (gender, clinical AIDS at baseline, nadir CD4, ART initiation year, ART class, intravenous drug use, time to ART modification and site). Results: Among 21,716 patients initiating ART between 1996 and 2014, 2530 (12%) were ≥ 50 years. Older patients were more likely to have heterosexual sex as their probable route of infection (32% vs. 29%; p<0.001). The majority of patients in both ≥ 50 and < 50 age groups received an NNRTI-based regimen (81% vs. 79%), were male (63%), and did not have AIDS at baseline (60%). Differences between groups in baseline CD4 and log 10 viral load were not significant. Older patients had a higher risk of death (adjusted hazard ratio (AHR) 1.71; 95%CI: 1.52-1.92) and a lower risk of virologic failure (AHR: 0.74; 95%CI: 0.65-0.85); differences in risk of ART regimen modification were not significantly different (AHR: 1.00; 95%CI: 0.94-1.07) (Figure). Risk factors for death, virologic failure, and treatment modification were similar for each group (results not shown). Conclusions: In this study from diverse HIV care sites in Latin America, we found that older patients had a higher risk of death but a lower risk of virologic failure compared to younger patients. Risk factors associated with these outcomes did not differ according to age. Given the complexity of issues related to aging with HIV- such as comorbid conditions, polypharmacy, immune senescence, and chronic inflammation- studies assessing the role of non-traditional HIV biomarkers and risk factors are needed.

Poster Abstracts

959 Immunovirological Responses to HAART Between HIV-1 Group O- and M-Infected Patients C. Kouanfack 1 ; M.Vray 2 ; A. Kfutwah 3 ; A. Aghokeng 4 ; R. Mougnutou 1 ; G. Unal 5 ; L. Le Fouler 2 ; L. Schaeffer 2 ; N. Noumsi 1 ; E. Alessandri-Gradt 5 ; Eric Delaporte 6 ; F. Simon 7 ; Jean-Christophe Plantier 8 ; for the DynaM-O Study Group 1 Hosp Central, Yaoundé, Cameroon; 2 Inst Pasteur, Paris, France; 3 Cntr Pasteur du Cameroun, Yaoundé, Cameroon; 4 Inst de Recherches Medes et d’Etudes des Plantes Medicinales, Yaoundé, Cameroon; 5 CHU de Rouen, Rouen, France; 6 UMI 233-IRD/U1175-INSERM/Montpellier Univ, Montpellier, France; 7 Hosp Saint Louis et Univ Paris Diderot, Paris, France; 8 Rouen Univ Hosp, Rouen, France Background: The divergent HIV-1 group O strains (HIV-1/O) are endemic in Cameroon and naturally resistant to NNRTI, largely used as first-line therapy in this country. Alternative therapeutic strategies are thus needed. DynaM-O is a prospective open-label study comparing the immuno-virological response to HAART, including two NRTI and one PI in HIV-1/O and HIV-1 group M (HIV-1/M) infected-naïve patients. Secondary objectives are to compare the kinetic of viral load responses and the CD4 restoration.

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CROI 2016