CROI 2015 Program and Abstracts

Abstract Listing

Poster Abstracts

a median 1.5 years – mortality rate [MR]: 7.6 per 100 person-years (PY). Mortality per 100 PY was 4.7 among HCV mono-infected and 13.2 among HIV/HCV co-infected persons (adjusted incidence rate ratio [IRR]: 3.6; 95% confidence interval [CI]: 1.6-8.3; Figure). Mortality was also significantly higher in those with cirrhosis (IRR: 2.4; 95% CI: 1.1, 5.2; Figure) and those with alcohol dependence (IRR: 6.1; 95% CI: 2.5, 14.6). Among 151 without significant fibrosis/cirrhosis at baseline, 38 (25%) progressed to significant fibrosis/cirrhosis over a median of 1.5 years (IRR: 16.1 per 100 person-years). Overall, 6% reported being linked to care for hepatitis C, and 2% reported receiving treatment for hepatitis C with none achieving sustained virologic response. The primary reasons for not taking treatment were negative perceptions about treatment (e.g., side effects, low perceived efficacy; 60%) followed by cost (26%) and competing priorities (11%).

Conclusions: High mortality among HCV- and especially HIV/HCV-coinfected persons, low treatment uptake, and negative perceptions regarding interferon- based regimens underscore the importance of efforts to deliver all-oral HCV treatment in RLS. 642 Chronic Kidney Disease Progression After HCV Seroconversion Adeel A. Butt University of Pittsburgh/VA Pittsburgh Healthcare System, Pittsburgh, PA, US Background: HCV infection has been associated with chronic kidney disease (CKD) progression and faster time to end stage renal disease. However, previous studies have been limited by lack of knowledge about timing of HCV infection and comparison with a comparable HCV uninfected population. Methods: In a well-established national cohort of HCV infected Veterans (ERCHIVES), we identified persons with a known window for HCV seroconversion based on a negative initial and a subsequent positive HCV antibody test and a detectable HCV RNA. Controls had two negative HCV antibody tests in a comparable time frame. We excluded those with HIV coinfection, positive hepatitis B surface antigen and baseline stage 3-5 CKD. Among HCV seroconverted group, those who received HCV treatment were censored at time of treatment initiation. Glomerular filtration rate (GFR) was estimated using the CKD-EPI equation, and CKD was determined based on 2 GFR values >90 days apart. Primary outcomes were development of incident stage 3-5 CKD (GFR<60 mL/min/1.73 m 2 )and progressive CKD (GFR decline >25% from baseline) among HCV seroconverted and uninfected groups. Results: Final dataset consisted of 2,589 seroconverted and 68,939 HCV uninfected persons. Median age was 51 and 55 years, 71% and 56%were White and 94% and 96% were men in the seroconverted and uninfected groups respectively. Among seroconverted group, 19% had diabetes, 50% had hypertension and 34% received ACE-inhibitors or angiotensin receptor blockers (ACE-I/ARB). Among HCV uninfected, 25% had diabetes, 66% had hypertension and 47% received ACE-I/ARB. Median baseline GFR (mL/min/1.73 m 2 ) was 86.1 in HCV seroconverted and 82.6 in HCV uninfected group (P<0.0001). Stage 3-5 CKD developed in 37.3% of seroconverted and 33.8% of uninfected group (P=0.0003). Progressive CKD developed in 42.4% of seroconverted and 33.3% of uninfected group (P<0.0001). HCV seroconverted had faster time to development of CKD (figure), but progressive CKD (GFR decline >25%) was not different among groups.

Poster Abstracts

Conclusions: This study provides new information about natural history of CKD among HCV seroconverted persons. HCV seroconverted persons were more likely to develop stage 3-5 CKD and accelerated time to incident stage 3-5 CKD. Interventions to decrease progression of CKD among HCV infected persons need further study.

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CROI 2015