7th IAS Conference on HIV Pathogenesis, Treatment and Prevention (IAS 2013)


WEAB02 Organ Dysfunction in HIV: It’s Complicated
  Oral Abstract Session : Track B Clinical Sciences
Venue: Session Room 2
Time: 03.07.2013, 14:30 - 16:00
Co-Chairs: Chureeratana Bowonwatanuwong, Thailand
Judith Feinberg, United States

14:30
WEAB0201
Abstract
Powerpoint
Webcast
Tenofovir nephrotoxicity in resource-limited setting of western India: higher rate of renal function decline, acute kidney injury and progression to chronic kidney disease compared to western data
A. Dravid1, A. Sadre2, S. Dhande1, A. Borkar1, M. Kulkarni1, M. Dravid3
1Ruby Hall Clinic, Department of HIV Medicine, Pune, India, 2Ruby Hall Clinic, Department of Nephrology, Pune, India, 3Infectious Disease Clinic, Department of HIV Medicine, Dhule, India

14:45
WEAB0202
Abstract
Powerpoint
Effects on renal function of a switch from tenofovir (TDF)- to abacavir (ABC)-based highly active antiretroviral therapy (HAART), with or without atazanavir
M. Harris1,2, S. Guillemi2,3, K. Chan3, B. Yip3, M. Hull2,3, V. Dias Lima2,3, R. Hogg3,4, J. Montaner2,3
1St. Paul's Hospital, AIDS Research Program, Vancouver, Canada, 2University of British Columbia, Vancouver, Canada, 3BC Centre for Excellence in HIV/AIDS, Vancouver, Canada, 4Simon Fraser University, Burnaby, Canada

15:00
WEAB0204
Abstract
Powerpoint
Webcast
HIV and HCV infections independently contribute to lower bone mineral density but have different effects on bone turnover markers
N. Maalouf1, H. Drechsler1,2, S. Zhang1, J. Cutrell1, G. Brown1,2, I. Farukhi2, P. Tebas3, R. Bedimo1,2
1University of Texas Southwestern Medical Center, Medicine, Dallas, United States, 2VA North Texas Health Care System, Medicine, Dallas, United States, 3University of Pennsylvania, Medicine, Philadelphia, United States

15:15
WEAB0205
Abstract
Powerpoint
HIV infection was associated with an increased risk of hip fracture, independently of age, gender and co-morbidities: a population-based cohort study
H. Knobel1, R. Güerri1, D. Prieto2, J. Villar1, A. Díez3, E. Lerma1, M. Montero1, A. González1, A. Guelar1
1Hospital del Mar, Infectious Diseases, Barcelona, Spain, 2Universitat Autònoma de Barcelona, IDIAP Jordi Gol Primary Care Research Institute, Barcelona, Spain, 3Hospital del Mar, Internal Medicine, Barcelona, Spain

15:30
WEAB0206
Abstract
Powerpoint
Webcast
Independent predictors of carotid intimal thickness differ between HIV+ and HIV- patients with respect to traditional cardiac risk factors, risk calculators, lipid subfractions and inflammatory markers
R. Hsu1, K. Patton2, J. Liang3, R. Okabe4, J. Aberg5, N. Fineberg2
1New York University Medical Center, Internal Medicine, New York, United States, 2University of Alabama at Birmingham, Biostatistics, Birmingham, United States, 3New York University, New York, United States, 4New York University, School of Medicine, New York, United States, 5New York University Medical Center, Infectious Diseases, New York, United States

15:45
WEAB0207
Moderated discussion

Powerpoints presentations
Tenofovir nephrotoxicity in resource-limited setting of western India: higher rate of renal function decline, acute kidney injury and progression to chronic kidney disease compared to western data - Ameet Dravid

Effects on renal function of a switch from tenofovir (TDF)- to abacavir (ABC)-based highly active antiretroviral therapy (HAART), with or without atazanavir - Silvia Guillemi

HIV and HCV infections independently contribute to lower bone mineral density but have different effects on bone turnover markers - Roger Bedimo

HIV infection was associated with an increased risk of hip fracture, independently of age, gender and co-morbidities: a population-based cohort study - Hernando Knobel

Independent Predictors of Carotid Intimal Thickness Differ Between HIV+ and HIV- Patients with Respect to Traditional Cardiac Risk Factors, Risk Calculators, Lipid Subfractions, and Inflammatory Markers - Ricky Hsu



Rapporteur report

Track B report by Jürgen Rockstroh


This session dealt mainly with short and long-term complications of antiretroviral therapy. The first study from Dravid et al. addressed issues around tenofovor associated nephrotoxicity in resource-limited settings. Interestingly, a higher incidence of acute kidney injury was reported amongst Tenofovir exposed patients from Western India compared to that seen in Western resource rich settings (4.8% vs 1 %). This could be attributable to lower baseline creatinine clearance, lower eGFR, lower baseline CD4 count and higher incidence of co-morbidities in the Indian cohort. A further study from Harris et al. looked at the effects on renal function after switching from abacavir to a tenofovor based regimen with or without atazanavir. In this study 225 patients that switched from TDF to ABC-based HAART showed a significant improvement in renal function (Creatinine, eGFR, phosphatemia and UACR), without significant changes in plasma HIV RNA. In addition the CD4 cell count increased and lipid profile remained stable after the  switch to ABC. Similar trends were observed whether or not  the third drug in the regimen was atazanavir. The authors concluded that switching from TDF to ABC-based HAART is effective, safe and also improves renal function parameters among patients who are responding to TDF-based HAART regardless of whether they are also on atazanavir. The third study presented in the complication session by Bedimo et al. evaluated bone mineral density changes in HIV and hepatitis C. Overall, HIV and HCV independently lowered BMD and T-scores (smaller contribution for HCV). The effect was most pronounced in femoral neck and total hip. No interaction was noted between the two infections The HIV impact on BMD could be explained by increased turnover (resorption and formation markers). The next study by Knobel et al. studied the risk of fractures in HIV+ versus HIV- subjects. They found a strong association between HIV infection and hip fracture incidence , with an almost 5-fold increased risk in the HIV-infected patients, independently of gender, age, body mass index, smoking, alcohol consumption and other co-morbidities. Overall, a 75% higher risk of all clinical fractures among HIV-infected patients was found underlining the need for more bone research in this patient population. Finally Hsu et al reported on independent predictors of carotid intimal thickness and differences between HIV+ and HIV- patients with respect to traditional cardiac risk factors, risk Calculators, lipid subfractions, and inflammatory markers. Today, with HIV suppression, lipid, and hypertension control, HIV+ patients continue to have a disproportionately greater CIMT and calculated heart age than HIV- comparators. Although HIV+ patients generally had lower HDL than their HIV- counterparts, HDL was not an independent predictor of atherosclerosis in HIV+ patients, in contrast to the HIV- cohort. In the context of LDL control in this HIV+ patient population, LDL size was predictive of ICA CIMT.  In the comparator HIV- population, HDL and Large HDL Particle number was predictive at the CCA CIMT, while LDL number only was predictive at the ICA CIMT.




   

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