CROI 2015 Program and Abstracts

Abstract Listing

Poster Abstracts

variables (p<0.001). Independent predictors of change in sCD14 were randomization group, baseline sCD14, CD4 and HDL-cholesterol, and changes in weight, eGFR, hsCRP and sCD163; and for Lp-PLA 2 were baseline Lp-PLA 2 , LDL-cholesterol and IL-6, and changes in cholesterol, triglycerides, sCD14 and sCD163.

Conclusions: Initiation of ART with EVG/C/F/TDF led to greater decreases in sCD14 and Lp-PLA 2 changes in sCD14, and changes in monocyte activation independently predicted changes in Lp-PLA 2

when compared with EFV/F/TDF. Randomization group independently predicted . There appears to be a different effect of the integrase inhibitor EVG compared

to EFV on HIV-related immune activation which may in turn impact vascular inflammation. 739 Impact of Antiretroviral Drugs on Hypertension in HIV-Positive Persons: D:A:D Study Camilla I. Hatleberg 1 ; Lene Ryom 1 ; Antonella d’Arminio Monforte 2 ; Eric Fontas 3 ; Peter Reiss 4 ; Ole Kirk 1 ;Wafaa M. El-Sadr 5 ; Stéphane DeWit 6 ; Jens D. Lundgren 1 ; Caroline Sabin 7 On behalf of the D:A:D Study group 1 Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; 2 San Paolo University Hospital, Milan, Italy; 3 Nice University Hospital, Nice, France; 4 Academic Medical Center, University of Amsterdam, Amstredam, Netherlands; 5 Columbia University, New York, NY, US; 6 Centre Hospitalier Universitaire St. Pierre Hospital, Brussels, Belgium; 7 University College London, London, United Kingdom Background: Previous studies have documented that hypertension in HIV-positive (HIV+) individuals is associated with traditional risk factors such as older age, male gender, diabetes, dyslipidemia and high body mass index (BMI). However, controversy remains as to whether the exposure to antiretroviral therapy (ART) poses additional risk. We investigated this issue in the D:A:D Study. Methods: The incidence of hypertension (systolic blood pressure (BP) >140 and/or diastolic BP >90 mmHg and/or initiation of antihypertensive treatment) in patients with normal BP at baseline was determined overall and in various strata defined by demographic, metabolic- and HIV-related factors, including cumulative exposure (/year) to each ART drug. Predictors of hypertension were identified using uni- and multivariable Poisson regression models, adjusted for potential confounders. Follow-up was from 1/2/99 until the earliest of confirmed hypertension, 6 months after last visit or 1/2/2013. Results: Of 33,278 included persons, 7636 (22.9%) developed hypertension over 223,149 person years (PYRS) (rate ratio (RR): 3.42 [95% CI 3.35-3.50]/100 PYRS). The demographic and HIV-related factors independently associated with a significantly increased rate of hypertension in multivariable models were male gender (RR 1.39 [1.30-1.48]), older age (vs. <30 years): 30-39 years (1.58 [1.37-1.82]); 40-49 years (2.60 [2.27-2.99]); 50-59 years (4.15 [3.60-4.78]); >60 years (6.09 [5.24-7.08]), black African origin (1.39 [1.25-1.54]), mode of HIV acquisition via injection drug use (1.09 [1.01-1.18]) and previous AIDS diagnosis (1.15 [1.09-1.20]). In univariate analyses, there were significant associations between cumulative exposure to almost all ART drugs and risk of hypertension. However, after adjustment for demographic, HIV-related factors and smoking, only abacavir, nevirapine, ritonavir and indinavir continued to be significantly associated with an increased risk of hypertension, although effects were small (Table). The estimates were similar when additionally adjusting for metabolic factors potentially on the causal pathway (Table).

Poster Abstracts

454

CROI 2015