CROI 2018 Abstract eBook

Abstract eBook

Poster Abstracts

median CD4 nadir 215/mm 3 (IQR 98-336) and current 491/mm 3 (IQR 285-710), on antiretroviral therapy (ART) 82%, HIV RNA <50 copies/mL 59%. Table 1 depicts HAND prevalence and NPZ8 according to HCV status (1a) and to Fib4 score strata in all pts (1b) and in HCV+RNA+ pts (1c). A higher prevalence of HAND together with lower median NPZ8 scores were found in HCV+ pts (with or without HIV RNA) and with higher Fib4. In HCV+RNA+ pts, frequency of HAND was similar across Fib4 stages. Adjusting for demographics and clinical variables (age, education level, current and nadir CD4 count, HIV-RNA, mode of HIV transmission, years from HIV test, ART, Fib4), HCV+RNA+ was associated to higher risk of HAND [OR 1.51(1.06-2.13), p 0.021]. When excluding the variable age from the model, Fib4 >3.25 had higher risk of HAND [OR 2.04(1.15-3.61), p 0.015]. Conclusion: Our results show that both, HCV co-infection and worse liver function scores were associated with detrimental neurocognitive performance in HIV+ pts. Notably, among pts with actively replicating HCV, NCI was not influenced by liver function scores. Now that curative anti-HCV therapy is available, these findings need further investigation.

for hemochromatosis [HFE] and activity of uroporphyrinogendecarboxylase [UROD]), clinical diagnosis and previous treatment. We followed the evolution of the disease after classic treatment, comparing it with that after achieving HCV virological response. SPSS22.0 Results: 13 patients: mean age 57 y.o.; 9 males; RG: 6 former IDU, 1 MSM; 8 HIV co-infected (among these: 7 with HIV suppressed VL, median CD4 cell count: 663 cells/ml). HCV genotype: 5 G1a, 5 G1b, 1 G3, 2 G4; fibrosis stage: F1-2: 7, F3: 3 and F4: 3; DAA regimen: SOF/LDV 5, OMB/PTV/DSB 5, OMB/PTV 1, SOF+DAC 1, SOF+SIM 1; all achieved sustained virological response at 12thweek after DAA. Risk factors for PCT: 12 smokers, 4 active alcohol consumption, 1 HT, 1 DL, no DM. Genetic tests performed in 8 patients: UROD activity normal in 8; C282Y heterozygosis in 1/8 and H63D heterozygosis in 6/8. Baseline total/fractionated porphyrins in urine were high in the 6 patients in which were available. PCT Symptoms&Evolution: blisters in photo-exposed skin in 11, scarring in 4, malar hypertrichosis in 1. PCT treatment: phlebotomy in 10, chloroquine in 5. With PCT treatment 10/13 improved skin activity (4 complete resolution), 3 symptomatic: 2 worsened and 1 without changes. After HCV eradication by DAA (among 9 remaining symptomatic patients) 8 (6 totally/ 2 subtotally) improved their symptoms but in 1 patient skin symptoms restarted. 3/13 stopped their PCT treatment but 1 restarted phlebotomies. Conclusion: PCT is not rare among our HCV patients. It is interesting the association found to H63D polymorphisms. Classic could fail to control it, but after viral eradication with DAA regimens skin activity stopped in all but one of our patients. 635 INFLAMMATION AND IMMUNE ACTIVATION MARKERS IN HEPATITIS C INFECTION AND CLEARANCE Ruibin Wang 1 , Chloe Thio 1 , Otoniel Martínez-Maza 2 , Steven Wolinsky 3 , Yue Chen 4 , Eric C. Seaberg 1 1 Johns Hopkins University, Baltimore, MD, USA, 2 University of California Los Angeles, Los Angeles, CA, USA, 3 Northwestern University, Chicago, IL, USA, 4 University of Pittsburgh, Pittsburgh, PA, USA Background: Hepatitis C virus (HCV) coinfection leads to an increased risk of liver disease and mortality among people living with HIV. While some inflammatory cytokines and chemokines are elevated in HCV infection, their relation to an effective immune response resulting in HCV clearance is unclear. We examined serum levels of 23 markers of inflammation and immune activation and a liver-derived acute phase reactant, C-reactive protein (CRP), for association with acute HCV infection and spontaneous clearance in a cohort of HIV-infected men who have sex with men (MSM) from the Multicenter AIDS Cohort Study (MACS). Methods: We included 1,887 MSM with known HCV status who contributed inflammation marker measurements at 12,028 person-visits from 1984 to 2009. HCV status was determined by anti-HCV and HCV RNA and categorized into three groups: HCV-uninfected (reference group), infected and cleared. Serum biomarker levels were quantified with two multiplex assay platforms. CRP was measured with high-sensitivity immunophelometric assay. To compare the levels of biomarkers across three HCV groups, we used conventional generalized gamma models with robust variance to account for repeated biomarker measurements, adjusting for age, race, hepatitis B infection, body mass index, injection drug use, smoking, alcohol use, HIV serostatus, antiretroviral therapy use and plasma HIV RNA levels. Results: Among HCV-infected men, serum levels of a number of pro- inflammatory cytokines and chemokines were significantly elevated. In contrast, CRP and three chemokines that are involved in antibody production including CCL17, CCL11 and CCL13 were down-regulated. Following spontaneous HCV clearance, most biomarkers were normalized. However, several pro- inflammatory markers, including BAFF, IL6, IFNγ, TNFα, IL10, CXCL13 and soluble IL6 receptor (sIL6R), remained elevated even after the clearance of HCV infection. Conclusion: Our results suggest that HCV infection is characterized by a complex dysfunction of cytokine/chemokine network, representing an immune hyperactive state. In contrast, lower CRP levels in HCV-infected men likely reflect decreased CRP production due to HCV-induced liver damage. After HCV clearance, several markers involved in immune activation (IFNγ, IL10, CXCL13 and sIL6R) remain higher than levels present in HCV-uninfected men. Further examination of the immune response during early phase of HCV infection and how it impacts disease establishment and progression is needed.

Poster Abstracts

634 PORPHYRIA CUTANEA TARDA EVOLUTION IN HCV+/HIV+/- PATIENTS POST TREATMENT WITH HCV DAA Lucio Jesus Garcia-Fraile Fraile , Pablo Rodríguez, Luisa Consuelo García Buey,

Concepción Alonso Cerezo, Ignacio d. Santos Gil Hospital Universitario de La Princesa, Madrid, Spain

Background: PCT is an extrahepatic manifestation found in HCV patients. Former treatment was based on phlebotomies and chloroquine, not always able to get a maintained improvement on symptoms. We want to analyse PCT evolution after achieving HCV eradication with DAA. Methods: Retrospective study via medical histories review of PCT patients treated with DAA in our hospital (Infectious & Digestive Units). We collected baseline characteristics: age, sex, risk group[RG], HIV infection (in these, baseline CD4 cell count and HIV viral load[VL]). Referred to HCV: genotype, VL, fibrosis stage by fibroscan, DAA regimen and virological response. For PCT: prevalence of associated risk factors (hypertension[HT], diabetes mellitus[DM], dyslipidemia[DL], smoking, alcohol, and genetic polymorphisms

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