CROI 2015 Program and Abstracts

Abstract Listing

Poster Abstracts

Figure: Cumulative incidence of loss to follow up during the first 12 months following cART initiation by sex and pregnancy status at enrollment, VU/FGH Nigeria program (for individuals who were initiated on cART within 90 days of enrollment, n= 2124). Conclusions: Pregnancy status had a favorable impact on early ART initiation, but did not influence 1-year retention rates in this large cohort of HIV-infected patients in rural Nigeria. These findings highlight the importance of addressing retention across all patient groups, regardless of sex and pregnancy status. 559 Randomised Controlled Trial of Text-Message Dosing Reminders in Patients Starting ART Catherine Orrell 1 ; Karen Cohen 1 ; Katya Mauff 1 ; David R. Bangsberg 2 ; Gary Maartens 1 ; RobinWood 1 1 University of Cape Town, Cape Town, South Africa; 2 Harvard Medical School, Boston, MA, US Background: Some studies have shown that antiretroviral therapy (ART) adherence could be improved with mobile phone text message reminders, while other studies have shown that patients rapidly habituate to reminders. We hypothesized that text message reminders, sent only when dosing is late, as recorded by real-time electronic adherence monitoring devices (EAMD), would improve adherence and HIV viral suppression over 48 weeks compared to standard of care (SoC). Methods: The study was conducted in an outpatient ART clinic in South Africa. ART-naïve participants were randomised (1:1) to SoC, including three pre-treatment group education sessions, or intervention, which comprised SoC with the addition of an automated text message reminder to their mobile phone if dosing was >30 minutes late. Staff and participants were not blinded to study arm. All participants were given EAMD at ART start and followed for 48 weeks. Bloods for CD4 cell count and viral load were drawn at baseline, weeks 16 and 48. Outcomes included the proportion of doses taken over the time on study as recorded by EAMD, and plasma HIV-1 viral load suppression (<40 copies/ml) at week 48. The analysis was intention to treat (missing=failure). The trial was registered with the Pan African Clinical Trial Registry: PACTR201311000641402. Results: Between July 2012 and March 2013, 230 participants were randomly assigned to the standard of care (n=115) or intervention (n=115) arms. Median adherence by EAMD was 82.1% (IQR 56.6-94.6%) in the intervention arm, compared to 80.4% (IQR 52.8-93.8%) in the SoC arm (aOR for adherence 1.08, 95%CI: 0.77-1.52, p=0.642). Suppressed viral loads (<40 copies/ml) were seen in 80 (69.6%) of control and 75 (65.2%) of intervention (missing = failure; aOR for virological failure in intervention arm 0.77, 95%CI: 0.42-1.40, p=0.393) at week 48.

Poster Abstracts

Conclusions: Text message reminder linked to late doses detected by real-time adherence monitoring did not significantly improve adherence or HIV viral suppression. 560 Socioeconomic Factors and Virological Rebound: A Prospective UK Cohort Study Lisa S. Burch 1 ; Colette Smith 1 ; Jane Anderson 3 ; Lorraine Sherr 1 ; Alison Rodger 1 ; Richard GIlson 1 ; Jonathan Elford 2 ; Andrew N. Phillips 1 ; Margaret Johnson 4 ; Fiona Lampe 1 ASTRA (Antiretrovirals, SexualTransmission Risk and Attitudes) 1 University College London, London, United Kingdom; 2 City University London, London, United Kingdom; 3 Homerton University Hospital NHS Foundation Trust, London, United Kingdom; 4 Royal Free London NHS Foundation Trust, London, United Kingdom Background: Little is known about the effect of social deprivation on HIV treatment outcomes in the UK, a setting with universal free access to health care. We assessed the association of socio-economic factors with subsequent virological rebound among individuals with initial virological suppression on ART. Methods: ASTRA is a questionnaire study of 3258 HIV-diagnosed individuals from 8 UK HIV clinics in 2011/2012, with longitudinal linkage to clinical records for consenting participants (92%) at 4 clinics. We included those who had received ART for >6 months, had viral load (VL) ≤ 50 c/mL at the time of the questionnaire (baseline) and with ≥ 1 subsequent VL measure. Individuals were followed from baseline until virological rebound (1 st VL>200 c/mL) or last available VL (latest April 2014). Self-reported non-adherence was defined as the number of times ≥ 2 consecutive days of ART was missed in the 3 months prior to baseline (0; 1; ≥ 2). Follow-up was not censored if ART was interrupted. We assessed the association of each socio-economic factor (financial hardship, employment, housing, education, time in UK, English reading ability, supportive network) with virological rebound in a separate Cox regression model, adjusted for (i) demographic factors (gender/sexual orientation; ethnicity; age; clinic); (ii) demographic factors and baseline non-adherence. Sensitivity analyses considered rebound as 2 consecutive VL>200 c/mL.

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CROI 2015