CROI 2015 Program and Abstracts

Abstract Listing

Poster Abstracts

Conclusions: We did not find evidence for any strong independent association between exposure to any of the ART drugs and the risk of hypertension. Established risk factors for hypertension in the general population were confirmed in this population of HIV+ persons, providing reassurance that screening policies for hypertension in HIV+ persons should follow algorithms used for the general population. 740 Population-Based Assessment of Hypertension Among HIV Patients in Rural Uganda Dalsone Kwarisiima 1 ; Prashant Kotwani 3 ; Norton Sang 4 ; Florence Mwangwa 2 ;Vivek Jain 3 ; Dathan Byonanebye 2 ; James Ayieko 4 ; Laura Balzer 5 ; Diane Havlir 3 ; Moses R. Kamya 6 1 Makerere University Joint AIDS Program, Kampala, Uganda; 2 Infectious Disease Research Collaboration, Kampala, Uganda; 3 University of California San Francisco, San Francisco, CA, US; 4 Research Care Training Program, Kenya Medical Research Institute, Nairobi, Kenya; 5 University of Berkeley, Berkeley, CA, US; 6 Makerere University College of Health Sciences, Kampala, Uganda Background: Following ART scale-up, there is an aging HIV+ population at risk for non-communicable diseases such as hypertension (HTN). We estimated HTN prevalence among adults ≥ 18 years attending multi-disease health campaigns in 20 rural Ugandan communities in the SEARCH Study (NCT01864603). We investigated (a) HIV as an independent risk factor for HTN, given conflicting prior literature on this topic, and (b) awareness and control of hypertension in HIV+ adults. Methods: Blood pressure (BP) was measured on 65,274 adults by sphygmomanometry. HTN was defined as SBP ≥ 140 or DBP ≥ 90 on 3 repeat measurements or self-reported current use of anti-hypertensives. We tested for HIV and collected demographics, body mass index (BMI), socio-economic status (SES), education, and alcohol use on all participants. We computed the crude and standardized prevalence of HTN within the population sample as well as estimates normalized to WHO standard population distribution. Logistic regression (adjusting for demographics, BMI, SES, education, alcohol use, region [east vs. west Uganda], viral load and CD4 count) was used to identify independent predictors of HTN among HIV+ persons. Results: Overall, adult prevalence of HTN was 12.9% (95%CI: 12.6%-13.1%), and was 15.6% normalized to WHO standard population. After multivariate adjustment, significant predictors of HTN included older age, male sex, higher BMI, no education, more alcohol use, region and HIV infection. The adjusted relative odds of HTN were 1.2-times higher among HIV negatives than positives (95%CI: 1.05-1.35). Among HIV+ adults, hypertension prevalence was 10.2% (95%CI: 9.2%-11.2%). Among HIV+, HTN+ adults, 79.1% had no prior HTN diagnosis and 14.5% reported being on HTN treatment. Among HIV+ HTN+ adults on treatment, 53.7% achieved BP control. In multivariate analyses, significant predictors for HTN were older age, higher SES and region. Viral suppression of HIV did not significantly predict HTN. Conclusions: In this large Ugandan study, we found a substantial prevalence of hypertension in the general population and among HIV positives. The majority was previously undiagnosed. HIV positivity predicted lower odds of HTN after adjustment for common risk factors, consistent with smaller previous African studies. Prospective data with more extensive adjustment for confounding by SES and other factors are needed to understand the reason for this association.

Poster Abstracts

TUESDAY, FEBRUARY 24, 2015 Session P-P4 Poster Session

Poster Hall

2:30 pm– 4:00 pm What Predicts Risk for CVD in HIV? 741 CD4/CD8 Ratio, Age, and Serious Noninfectious Outcomes in HIV-Infected Adults Jessica L. Castilho ; MeganTurner; Sally Bebawy; Bryan E. Shepherd;Timothy Sterling Vanderbilt University School of Medicine, Nashville, TN, US

Background: In virologically suppressed HIV-infected adults, CD4/CD8 ratio has been inversely associated with risk of non-communicable diseases (NCDs). Very low CD4/CD8 ratio (<0.4) despite antiretroviral therapy (ART) also correlates with higher measures of immunosenescence. The interaction of age and CD4/CD8 and its association with future NCD events has not been described.

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CROI 2015