CROI 2018 Abstract eBook

Abstract eBook

Poster Abstracts

Netherlands, Germany, and the United Kingdom. Phylogenetic analysis linked the outbreaks in Asia and Europe with transmission presumably through oral-anal sexual contact. No outbreak of HAV had been reported in the Bangkok metropolitan area since 2002. Methods: The RV254/SEARCH010 cohort has recruited participants with acute HIV infection (AHI) since 2009. A total of 478 individuals enrolled through June 2017. No cases of acute HAV (anti-HAV IgM+ with symptoms of acute hepatitis) were identified until 2017. HAV phylogenetic analysis used a 378 bp sequence of vp1 compared to reference sequences from GenBank. The phylogenetic tree was produced in MEGA V6.0. Results: Five cases of acute HAV were identified in the cohort in March-May 2017. All were symptomatic, with abdominal pain (n=5), fatigue (5), jaundice (3), fever (3), and nausea/vomiting (2) most frequently reported. All were male, median age 37 years (range 20-43). None had recent travel outside of Thailand. All reported male sexual partners within the preceding 3 months. Median (range) laboratory abnormalities included peak ALT 760 (572-2611) IU/L, total bilirubin 5.7 (3.4-7.8) mg/dl, and direct bilirubin 5.4 (2.5-5.9) mg/dl. Four cases were on antiretroviral therapy a median 19.5 (range 7-53) months; all with HIV RNA <20 copies/ml and median (range) CD4 804 (602-1008) cells/mm 3 . The fifth case was diagnosed with acute HAV simultaneously with AHI and had HIV RNA 7.2 log 10 copies/ml and CD4 132 cells/mm 3 . HAV was sequenced from 3 cases; phylogenetic analysis showed 100% concurrence between the Bangkok MSM cases with HAV in recent Taiwan and Netherlands outbreaks (Figure 1). An additional female case in Bangkok not in the cohort and not known to have HIV (ChulaCU22-HAV17) was diagnosed in June 2017 with 99.7% similarity to the MSM cases on the 378 bp sequence and 99.9% similarity to the first identified MSM case on a longer 1110 bp sequence. Conclusion: This is the first outbreak of acute HAV reported among HIV- infected MSM in SE Asia, and the first HAV outbreak locally transmitted in Bangkok since 2002. Phylogenetics shows that the Bangkok HAV cases are linked to outbreaks among MSM in Europe and Taiwan, most likely imported to Thailand by one or more MSM and transmitted locally via sexual networks.

prevalence and infection’s route of HEV in people infected by HIV (PLHIV) and the interaction with HBV and HCV. Methods: Design: Cross sectional study in a single center in southern France. Patients: Patients attending at the ID department at “Centre Hospitalier de la Côte Basque” were included after writing consent from July 2016 to January 2017. Patient were tested for anti HEV IgG /IgM (Wantai Elisa) by the FRC for Hepatitis E. HBV, HCV and Syphilis were also tested with regular follow-up. HEV RNA assay was performed for anti-HEV IgM positive patients. Self-administered questionnaires were realized the same day to investigate routes of contamination. Definition of cases: Patients positive for HEV IgG, HCV IgG, HBc IgG and syphilis (TPHA/VDRL tests) were considered as exposed for these infections. Statistical analysis: Factors associated with HEV status were determined by multivariate analysis. Clinical Trial number: NCT02847507 Results: 307 patients were included. Patients were 52 years old,72%were men, 99,8% were on antiretroviral, median CD4 count was 744 c./mm 3 , and 92% of patients were undetectable for HIV. Prevalence for HEV, HCV, HBc and TPHA were 21, 19, 37 and 24% respectively, 11.7%were positive for HEV and another hepatitis virus. In univariate analysis, diet, countries, and sexual orientation weren’t associated with HEV. HEV+ patients were older, had significantly: higher transaminases, lower CD4, CD8 counts but same CD4/CD8 ratio. Seafood once week and pigs’ meat bought at the farmwere associated with HEV while CD4<200 c./mm 3 was negatively associated with HEV. In multivariate analysis, patient with markers of syphilis, were more likely to be HEV+, OR=2.84 and 3.8 for TPHA and VDRL (p < 0.05). Eight of the 52 HCV+, were positive for HEV but fibroscore® wasn’t different (0.41 Vs 0.31, p=0.20, F2). Conclusion: Prevalence of HEV is high in PLHIV, and often associated with exposure to other hepatitis. HEV is associated with lower CD4 count but not with CD4/CD8 ratio and fibrosis score in HIV/HCV patients. Usual routs of transmission were not found in our settings, but past history of syphilis was associated with HEV status, suggesting possible similar ways of transmission.

Poster Abstracts

628 HEPATITIS C VIRUS AND HUMAN PEGIVIRUS 2 SURVEILLANCE IN A LARGE CAMEROONIAN COHORT Mary Rodgers 1 , Vera Holzmayer 1 , Ana Vallari 1 , Ana Olivo 1 , Kenn Forberg 1 , Jill Fuhrman 1 , Kelly Coller 1 , Bih Awazi 2 , Jules Bertrand Kenmegne Sidje 2 , Matthew Frankel 1 , Michael Berg 1 , Dora Mbanya 2 , Nicaise Ndembi 3 , Gavin Cloherty 1 1 Abbott Labs, Abbott Park, IL, USA, 2 University of Yaoundé, Yaounde, Cameroon, 3 Institute of Human Virology Nigeria, Abuja, Nigeria Background: Hepatitis C virus (HCV) is a major global health burden that threatens more than 100 million people with chronic infections and human pegivirus 2 (HPgV-2) is a recently discovered flavivirus largely restricted to HCV patients. Estimates of the global burden of HCV and HPgV-2 rely on surveillance of diverse populations; however, limited data are available on the prevalence of these viruses in sub-Saharan Africa. To characterize the relative prevalence of HCV and HPgV-2 in South Cameroon, well characterized archived samples were screened for HCV RNA, and positive specimens were then screened for HPgV-2 antibodies and RNA. Methods: Plasma specimens were received from N=12,462 consenting subjects participating in surveillance studies in South Cameroon collected from 2012 – 2016. Within this cohort, N=7737 HIV negative and N=4725 HIV positive specimens were screened for HCV RNA using the Abbott RealTime HCV viral load test. HCV RNA positive specimens with remaining volume were also screened

627 SEROPREVALENCE AND RISK FACTORS OF HEPATITIS E AMONG PLHIV IN SOUTH WESTERN FRANCE Marc Vareil 1 , Florence Abravanel 2 , Heidi Wille 1 , Anne-Christine Jaouen 1 , David Leyssene 1 , Jacques Izopet 2 1 Centre Hospitalier de la Côte Basque, Bayonne, France, 2 Toulouse University Hospital, Toulouse, France Background: Hepatitis E virus is a common fecal-oral transmitted virus highly prevalent in southern France. Study’s objective is to investigate the

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