CROI 2015 Program and Abstracts

Abstract Listing

Poster Abstracts

Table 1. Adjusted hazard ratios for lung cancer by CD4, CD4/CD8 ratio, and CD8 exposures. Conclusions: In our large HIV cohort, we found that several measures of recent and cumulative exposure to immunodeficiency were associated with increased lung cancer risk. CD4 count at time of cancer diagnosis was not associated with cancer-specific survival after accounting for competing risk of non-lung cancer death.

TUESDAY, FEBRUARY 24, 2015 Session P-P1 Poster Session

Poster Hall

Poster Abstracts

2:30 pm– 4:00 pm Cardiovascular Disease Outcomes 729 Cardiovascular Disease Mortality Among HIV-Infected Persons, New York City, 2001–2012 David B. Hanna 1 ; Chitra Ramaswamy 2 ; Robert C. Kaplan 1 ; Regina Zimmerman 2 ; Sarah L. Braunstein 2 1 Albert Einstein College of Medicine, Bronx, NY, US; 2 New York City Department of Health and Mental Hygiene, Long Island City, NY, US

Background: Cardiovascular disease (CVD) has become more prominent among HIV-infected individuals owing to improved survival, traditional CVD risk factors, and potential effects of antiretroviral therapy (ART). The extent to which CVD mortality rates are changing is unclear but has continued relevance in the context of current ART guidelines. Methods: The population comprised all persons age 13+ with HIV infection between 2001 and 2012 reported to the New York City HIV Surveillance Registry. Surveillance data were linked with the city Vital Statistics Registry and National Death Index. We examined age-specific and standardized rates of mortality due to major cardiovascular diseases, ICD-10 codes I00-I78. Using log-linear models, we determined time trends in mortality rates among HIV-infected New Yorkers, and compared themwith trends among HIV- uninfected New Yorkers derived from Vital Statistics and Census data. Analyses by HIV RNA level began in 2006, the first complete year of comprehensive viral load reporting in New York. Results: There were 145,009 HIV-infected individuals (1,226,883 person-years) analyzed. Between 2001 and 2012, 29,326 deaths occurred, with annual declines due primarily to fewer HIV-related deaths. Ten percent of deaths were attributed to major cardiovascular diseases, including chronic ischemic heart disease (42% of CVD deaths), hypertensive diseases (27%), and cerebrovascular diseases (10%). While the proportion of deaths due to CVD among HIV-infected individuals increased during the period (6% to 14%, p<0.001), the CVD mortality rate among HIV-infected individuals decreased, from 5.4/1000 person-years (95% CI 3.5-7.3) to 2.3 (95% CI 2.0-2.7). After controlling for sex, race/ethnicity, borough of residence, and year, HIV-infected individuals had a significantly higher CVD mortality rate than uninfected individuals in all age groups through age 65, after which CVD mortality was similar or higher in uninfected individuals. CVD mortality was lower among HIV-infected individuals whose last HIV RNA level of each year was suppressed (<400 copies/mL) versus unsuppressed (3.9 vs. 7.7/1000, p<0.001). Conclusions: While CVD mortality rates decreased over the decade, both viremic and virologically suppressed HIV-infected individuals had higher CVD mortality rates than uninfected individuals until age 65. HIV care providers should continue to emphasize preventive measures such as smoking cessation, blood pressure control, and lipid management to reduce CVD risk.

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CROI 2015