CROI 2015 Program and Abstracts

Abstract Listing

Poster Abstracts

Conclusions: Living more than 95% of time on ART fully suppressed provides the best outcome from use of ART. If %FS is 80-95% this provides reasonable outcome, whereas %FS below 80% provides suboptimal outcome. %FS is a novel indicator to evaluate ART programs, warranting further examination, that may provide a more comprehensive picture of standard-of-ART-care than existing WHO evaluation criteria, and will aid further improvement in quality of care efforts. 562 Viremia Copy Years and Its Impact on Risk of Clinical Progression According to Shape Alessandro Cozzi-Lepri 1 ; Antonella Cingolani 2 ; Andrea Antinori 3 ; Andrea De Luca 4 ; Cristina Mussini 5 ; Stefano Rusconi 6 ; Carmela Pinnetti 3 ; Massimo Galli 6 ; Antonella Castagna 8 ; Antonella d’Arminio Monforte 7 1 University College London, London, United Kingdom; 2 Sacro Cuore University, Roma, Italy; 3 INMI Spallanzani, Roma, Italy; 4 University of Siena, Siena, Italy; 5 University of Modena, Modena, Italy; 6 Luigi Sacco University Hospital, Milano, Italy; 7 S. Paolo Hospital, Milano, Italy; 8 San Raffaele Scientific Institute, Milano, Italy Background: Viremia copy-years (VCY), a measure of cumulative HIV burden approximated by the area under a patient’s viral load (VL) curve (AUC), was shown to predict mortality independently of VL and current CD4 count in ART-treated patients. For a given AUC, its shape (e.g. a VL of 10,000 copies/mL for 1 year) might help identifying patients (pts) whose VL/ART history differ from that of pts with other shapes (e.g. a VL of 1,000 copies/mL for 10 years). Methods: All pts who were enrolled in the Icona Foundation study and who started cART after January 1, 2000 were included. VCY (log10 scale) was calculated using the trapezoidal rule. Cox proportional hazards regression model was used to estimate the relationship between VCY and two endpoints (AIDS/death and severe non-AIDS[SNAE]/death) with time accruing from ART initiation. Multivariable models were constructed both controlling for CD4 count as time-updated covariate and using inverse probability weights (IPW). Pts were classified according to the quartiles of the proportion of AUC over the maximum rectangular with base the length of VL follow-up and height pts’ ever observed VL peak under ART. Roughly, a proportion of 100% identifies patients with stable VL trajectory at peak level while low percentages people with dips and spikes in VL. Results: We included 5,376 pts in Icona with the following characteristics: 36%MSM, 84%of Italian nationality withmedian (range) age of 37 (18-78) years, who started cART on average in 2010, 54% started PIr-based cART. By the end of follow-upmedian (IQR) of VCY was 5.27 (2.69-11.19 log10 copies/mL). The quartiles of the VCY distribution identified the following groups: A: 0-35%, B: 36-40%C: 41-55%and D: 56+%of maximum rectangular. We observed 175 AIDS, 187 SNAE and 69 deaths. The magnitude of risk associated with 1 log10 higher VCY was under-estimated when controlling for CD4 as time-updated covariate vs. IPW (e.g. for AIDS/death HR=1.10 vs. HR=1.19). Results of the stratified analysis are shown in Table.

Poster Abstracts

362

CROI 2015