CROI 2015 Program and Abstracts

Abstract Listing

Poster Abstracts

positive correlations between the trio expression, Ki67, LANA, VEGF and lesion severity ( r =0.63-0.81, p<0.0001). The trio expression also correlated with the proliferation rate ( r =0.50-0.69, p<0.002), latent HHV-8 level ( r =0.56-0.74, p<0.001) and VEGF expression ( r =0.41-0.77, p<0.02). No correlation was found with apoptosis level, patient age, CD4 + T cell count, lines of chemotherapy and KS disease duration. Conclusions: This is the first in vivo study that highlights a concomitant up-regulation of the CXCL12/CXCR4-CXCR7 axis in KS. Such deregulation correlates with the disease severity. The CXCL12 signaling axis may be implicated in this virus-related cancer and could serve as a biomarker of KS severity.

THURSDAY, FEBRUARY 26, 2015 Session P-O3 Poster Session

Poster Hall

2:30 pm– 4:00 pm Cancer and Cancer Risk in HIV Subpopulations and Lung Cancer 724 Cancer in HIV-Infected Children: Record Linkage Study in South Africa Julia Bohlius 6 ; Nicky Maxwell 2 ; Brian Eley 3 ; Hans Prozesky 4 ; Shobna Sawry 1 ; Karl-GünterTechnau 1 ; Alan Davidson 2 ; Cristina Stefan 5 ; Matthias Egger 6 On behalf of IeDEA Southern Africa 1 University of the Witwatersrand, Johannesburg, South Africa; 2 University of Cape Town, Cape Town, South Africa; 3 Red Cross War Memorial Children’s Hospital, Cape Town, South Africa; 4 University of Stellenbosch and Tygerberg Academic Hospital, Cape Town, South Africa; 5 Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa; 6 University of Bern, Bern, Switzerland Background: The incidence of AIDS- and non AIDS-defining cancers in HIV-infected children and the impact of ART has not been evaluated in sub-Saharan Africa. We examined the incidence of cancer in HIV-infected children enrolled in antiretroviral therapy (ART) programmes in South Africa, using record linkage techniques. Methods: We linked records of patients aged ≤ 16 years from five ART programmes (Harriet Shezi and Rahima Moosa in Johannesburg; Khayelitsha, Red Cross and Tygerberg in Cape Town) to the records of the four corresponding paediatric oncology units (Baragwanath and Charlotte Maxeke in Johannesburg; Red Cross and Tygerberg in Cape Town). Records were linked based on folder numbers, names, birth date and sex. Missing CD4 cell counts and percentages were multiply imputed. We calculated incidence rates and hazard ratios (HR) from Cox regression models including ART, sex, age, and immunodeficiency. Results: Data of 11,707 HIV-infected children (29,348 person-years [pys]) were included in the analysis. Median age at enrolment was 6 years in children developing and 2.5 years in children not developing cancer. We identified 24 incident cancer cases, for an incidence rate of 82/100,000 pys (95% CI 55-122). Kaposi Sarcoma and Non Hodgkin Lymphoma were the most frequent cancers with incidence rates of 34 and 31/100,000 pys, respectively. There were few non AIDS-defining malignancies. In multivariate analysis, children on ART had a lower risk of developing cancer compared to children not on ART. The risk of developing cancer increased with age and more advanced immunodeficiency (Table). In

children with cancer, one year survival was 73% (95% CI 61-82%). Risk of developing cancer among HIV-infected children in South Africa

Poster Abstracts

HR: hazard ratio, ART: antiretroviral therapy; CI: confidence interval Conclusions: ART reduces the risk of developing cancer in HIV-infected children in South Africa. Early linkage to care and early start of ART may help to further reduce the burden of cancer in these children. 725 High Cancer Risk Among the HIV-Infected Elderly in the United States Elizabeth L. Yanik ; Hormuzd A. Katki; Eric A. Engels National Cancer Institute (NCI), Rockville, MD, US Background: HIV-infected people have higher risk of many cancers compared to HIV-uninfected people, but it is unclear if the magnitude of this elevated risk is consistent across age groups. As the proportion of HIV-infected people over age 65 is increasing over time and the elderly population is known to have high cancer risk, it is important to understand the relationship between HIV and cancer in this age group. Methods: We conducted a case-cohort study that included a 5% sample of Medicare enrollees and all cancer cases ≥ 65 years of age identified through the Surveillance, Epidemiology, and End Results cancer registries. Non-melanoma skin cancers were not captured. HIV infection was defined through Medicare diagnosis claims. Weighted Cox regression was used to estimate associations between HIV and cancer incidence adjusting for age, race, sex, and calendar year. The absolute risk of cancer over time was calculated accounting for the competing risk of death. Results: Among 469,954 people in the 5%Medicare sample, 0.08% had an HIV diagnosis. In total, 835,450 cancer cases were identified in cancer registries. Among HIV-infected people, lung and prostate cancers were most common (N=111 each), followed by non-Hodgkin lymphoma (NHL) (N=57). HIV was strongly associated with incidence of Kaposi sarcoma, anal cancer and Hodgkin lymphoma (hazard ratios of 104, 30, and 12, respectively, Table 1). HIV was also associated with incidence of liver cancer, NHL, and lung cancer, but elevations in risk were lower (hazard ratios of 5, 3 and 2, respectively). Among NHL subtypes, HIV was associated with diffuse large B-cell lymphoma and Burkitt lymphoma, but no association was found with other specified NHL subtypes (which comprised 60% of cases in uninfected people). HIV was associated with lower prostate cancer incidence. Over a 1-year period, 2.5% of the HIV-infected elderly were diagnosed with cancer; by 5 years, this proportion increased to 10.2%.

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CROI 2015