CROI 2015 Program and Abstracts

Abstract Listing

Oral Abstracts

Levels of biomarkers of microbial translocation, inflammation, coagulation and fibrosis Conclusions: Enterocyte turnover increases after initiation of ART during acute infection and persists into chronic infection. Biomarkers of inflammation, microbial translocation and fibrosis decrease, but remain elevated compared to HIV- controls with the exception of D-dimer. Together, these data suggest that the inflammatory damage caused by HIV may not be completely prevented by starting ART during acute HIV infection 48 HIV Burden and Biomarker Associations With Colonic HIV RNA During Acute HIV Infection James L. Fletcher 2 ; Trevor A. Crowell 1 ; Robin Dewar 3 ; Irini Sereti 4 ; Bonnie Slike 1 ; Nitiya Chomchey 2 ; Rungsun Rerknimitr 5 ; Nelson L. Michael 1 ; Nicolas Chomont 6 ; Jintanat Ananworanich 1 RV254/SEARCH010 Study Group 1 US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD, US; 2 SEARCH, Thai Red Cross AIDS Research Centre, Bangkok, Thailand; 3 Virus Isolation and Serological Lab, National Cancer Institute at Frederick, Frederick, MD, US; 4 National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Bethesda, MD, US; 5 Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; 6 Vaccine and Gene Therapy Institute Florida, Port St. Lucie, FL, US Background: The colonic mucosa is typically one of the first sites infiltrated during acute HIV infection (AHI), becoming an important reservoir for the virus and a barrier to cure. We investigated virologic and immunologic correlates of detectable colonic HIV RNA during AHI. Methods: Subjects were prospectively enrolled and offered ART during AHI (Fiebig stages I-V) fromMay 2009 to March 2012 in Bangkok, Thailand. Sigmoidoscopy was performed to collect colon tissue. Subjects were categorized by detectable ( ≥ 50 copies/mg) or undetectable HIV RNA in colonic mucosal tissue cells using homogenized biopsy specimens and the Siemens Quantiplex HIV-1 3.0 assay. Biomarkers and HIV burden in multiple compartments were compared between groups using the Mann-Whitney U test. Results: From 49,458 samples screened for HIV, 75 individuals were enrolled during AHI and 42 consented to optional colon biopsy and are included in this analysis. The median age was 29 and 93%were male. Colonic HIV RNA was detectable in 32 subjects (76%). As compared to subjects without detectable colonic HIV RNA, those with detectable HIV RNA tended to be in a later Fiebig stage (19% Fiebig I in detectable group vs. 70% Fiebig I in undetectable group, p=0.04); had a longer reported duration since HIV exposure; had higher median levels of IP-10, TNF-RII and neopterin; and had higher expression of HLA-DR/CD38 and Ki-67 on CD8 cells in both blood and colon (Table 1). Median CD4 count in mucosal mononuclear cells was lower in volunteers with detectable colonic HIV RNA. Detectable colonic HIV RNA was also associated with higher HIV RNA levels in the peripheral blood and cerebrospinal fluid as well as higher levels of both total and integrated HIV DNA in both the peripheral blood and colon. Among subjects with baseline detectable colonic HIV RNA, 23 of 26 tested (88%) were undetectable after 24 weeks of ART. The eight tested subjects who were undetectable at baseline remained undetectable.

Oral Abstracts

Characteristics of Subjects during Acute HIV Infection, Stratified by Colonic HIV RNA

101

CROI 2015