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AIMS To compare patients who acquired HIV infection through use of injected drugs (HIV-IDU) with patients who acquired HIV by sexual transmission (HIV-ST) in terms of late presentation (LP), delay in anti-retroviral treatment (ART) initiation, virological and immunological response to ART, mortality and progression to AIDS. DESIGN Prospective multi-centre cohort study of HIV-infected subjects naive to ART at entry (Cohort of the Spanish HIV Research Network: CoRIS). SETTING Thirty-one centres from the Spanish public health-care system. PARTICIPANTS A total of 9355 patients were included (1064 HIV-IDU and 8291 HIV-ST) during 2004-13. MEASUREMENTS We compared LP (defined as presentation for care with a CD4 cell count

Purpose : Due to the relative low age of HIV-infected patients, Framingham risk score (FRS) usually estimates a low CVD risk. Lifetime risk estimations use the risk of developing CVD over the course of an individual's remaining lifetime and may be useful in communicating the risk of CVD to young patients. Our aim is to estimate the lifetime risk of CVD in a representative sample of HIV patients under antiretroviral therapy in Spain. Methods : Cross-sectional analysis in 10 HIV units across Spain, including information on demographics, HIV disease status, treatment history and cardiovascular risk factors of subject under ART. Lifetime CVD risk was calculated with the method of Berry et al, which classifies the lifetime risk in five mutually exclusive categories: 1. All risk factors are optimal; 2. At least one risk factor is not optimal; 3. At least one risk factor is elevated; 4. One major risk factor is present; and 5. Two or more major risk factors are present. Risk factors included are cholesterol level, blood pressure, diabetes and tobacco smoking. We grouped these five categories in two major groups, low-risk (groups 1+2+3) and high-risk category (groups 4+5). We calculated the prevalence of having a high lifetime risk, and its crude and aOR (adjusted by age, sex, place of origin, education level, transmission category, time since HIV diagnosis, CDC stage, current and nadir CD4 count, HCV coinfection, time on current and total ART, being on the first ART regimen, and PI vs. NNRTI regimen). Results : We included 839 subjects free of previous CVD disease: 72% men, median age 45.6y, median CD4 count 598 cells, median time since HIV diagnosis 11y, median time on ART 6.3y, 87% had undetectable VL. Estimated 10-year CVD risk was low (

Purpose : HIV-infected patients present an increased cardiovascular risk (CVR) of multifactorial origin, usually lower in women than in men. Information by gender about prevalence of modifiable risk factors is scarce. Methods: Coronator is a cross-sectional survey of a representative sample of HIV-infected patients on ART within 10 hospitals across Spain in 2011. Variables include sociodemographics, CVR factors and 10-year CV disease risk estimation (Regicor: Framingham score adapted to the Spanish population). Results : We included 860 patients (76.3% male) with no history of CVD. Median age 45.6 years; 84.1% were Spaniards; 29.9% women were IDUs. Median time since HIV diagnosis for men and women was 10 and 13 years (p=0.001), 28% had an AIDS diagnosis. Median CD4 cell count was 596 cells/mm 3 , 88% had undetectable viral load. Median time on ART was 91 and 108 months (p=0.017). There was a family history of early CVD in 113 men (17.9%) and 41 women (20.6%). Classical CVR factors are described in the table. Median (IQR) Regicor Score was 3% (2-5) for men and 2% (1-3) for women (p=0.000), and the proportion of subjects with mid-high risk (>5%) was 26.1% for men and 9.4% for women (p=0.000). Conclusions : In this population of HIV-infected patients, women have lower cardiovascular risk than men, partly due to higher levels of HDL cholesterol. Of note is the high frequency of smoking, abdominal obesity and sedentary lifestyle in our population. (Published: 11 November 2012) Citation: Abstracts of the Eleventh International Congress on Drug Therapy in HIV Infection Santos J et al. Journal of the International AIDS Society 2012, 15 (Suppl 4):18131 http://www.jiasociety.org/index.php/jias/article/view/18131 | http://dx.doi.org/10.7448/IAS.15.6.18131

Purpose: Among traditional cardiovascular risk factors, dyslipidemia could be particularly prevalent since virus, treatment and host factors may be involved in its development. Our analysis aimed to describe the prevalence of different types of dyslipidemia in a population of HIV-infected, treatment-experienced patients in Spain. Methods : Cross-sectional analysis within 10 HIV units across Spain. We collected data on demographics and cardiovascular risk factors, including lipid profile as well as information on current use of lipid-lowering drugs. This analysis describes subjects under first-line ART as compared with others in more advanced lines of treatment. Results : We included 860 patients (76.3% male) with no history of CVD, with median age 45.6 years. Median time since HIV diagnosis was 3 and 14 years (p=0.000) and median time on ART was 22 and 136 months (p=0.000) respectively. Lipid profile is described in the table. Conclusions: Dyslipidemia, especially low HDL and high TG, is highly prevalent in this population regardless being in their first or more advanced lines of treatment. The use of lipid-lowering drugs in our population is low and furthermore the control of dyslipidemia is not always achieved. Additional research is needed to understand how to achieve lipid goals in this population. (Published: 11 November 2012) Citation: Abstracts of the Eleventh International Congress on Drug Therapy in HIV Infection Estrada V et al. Journal of the International AIDS Society 2012, 15 (Suppl 4):18122 http://www.jiasociety.org/index.php/jias/article/view/18122 | http://dx.doi.org/10.7448/IAS.15.6.18122

Introduction : Due to their low CNS penetrance, there are concerns about the capacity of non-conventional PI-based ART (monotherapy and dual therapies) to preserve neurocognitive performance (NP). Methods : We evaluated the NP change of aviremic participants of the SALT clinical trial [1] switching therapy to dual therapy (DT: ATV/r+3TC) or triple therapy (TT: ATV/r+2NRTI) who agreed to perform an NP assessment (NPZ-5) at baseline and W48. Neurocognitive impairment and NP were assessed using AAN-2007 criteria [2] and global deficit scores (GDS) [3]. Neurocognitive change (GDS change: W48 – baseline) and the effect of DT on NP evolution crude and adjusted by significant confounders were determined using ANCOVA. Results : A total of 158 patients were included (Table 1). They had shorter times because HIV diagnosis, ART initiation and HIV-suppression and their virologic outcome at W48 by snapshot was higher (79.1% vs 72.7%; p=0.04) compared to the 128 patients not included in the sub-study. By AAN-2007 criteria, 51 patients in each ART group (68% vs 63%) were neurocognitively impaired at baseline (p=0.61). Forty-seven patients were not reassessed at W48: 30 lost of follow-up (16 DT-14 TT) and 17 had non-evaluable data (6 DT-11 TT). Patients retested were more likely to be men (78.9% vs 61.4%) and had neurological cofounders (9.6% vs 0%) than patients non-retested. At W48, 3 out of 16 (5.7%) patients on DT and 6 out of 21 (10.5%) on TT who were non-impaired at baseline became impaired (p=0.49) while 10 out of 37 (18.9%) on DT and 7 out of 36 (12.3%) on TT who were neurocognitively impaired at baseline became non-impaired (p=0.44). Mean GDS changes (95% CI) were: Overall −0.2 (−0.3 to −0.04): DT −0.26 (−0.4 to −0.07) and TT −0.08 (−0.2 to 0.07). NP was similar between DT and TT (0.15). This absence of differences was also observed in all cognitive tests. Effect of DT: −0.16 [−0.38 to 0.06]) (r 2 =0.16) on NP evolution was similar to TT (reference), even after adjusting (DT: −0.11 [−0.33 to 0.1], TT: reference) by significant confounders (geographical origin, previous ATV use and CD4 cell count) (r 2 =0.25). Conclusions : NP stability was observed after 48 weeks of follow up in the majority of patients whether DT or TT was used to maintain HIV-suppression. Incidence rates of NP impairment or NP impairment recovery were also similar between DT and TT. (Published: 2 November 2014) Citation : Perez Valero I et al. Journal of the International AIDS Society 2014, 17(Suppl 3) :19656 http://www.jiasociety.org/index.php/jias/article/view/19656 | http://dx.doi.org/10.7448/IAS.17.4.19656