bluuebunny/crossref_metadata_2025_split huggingface dataset:
P-515. Enhancing Sexual Wellness: A Novel Approach to Screening and Prevention in an Urban Health Center
Authors: Caponi Mitchell , Bonano Miriam , Bayter Eduardo , Keneipp Kathryn , Bhat Sandeep 
Published: January 2025

Abstract

Background
The Family Health Centers at NYU Langone (FHC) is a network of Federally Qualified Health Centers that serves a largely marginalized, diverse, and low-income patient population in Brooklyn, NY. In 2023, the FHC provided care for over 112,000 patients, with 52% being on Medicaid or Medicare and 28% being uninsured. We identified 44 HBSAG positive patients as well as 25 newly diagnosed HIV patients.
Patients as well as providers are often reluctant to have conversations around sexual health. Identifying risk factors for HIV, infectious hepatitis, and other infections is an area critical for providing excellent primary care to end the epidemic and curb Hep and STI rates.

Methods
The FHC had no standardized approach to collecting HIV and Hep B risk history being followed by providers. Our approach aimed to standardize risk screening processes while raising provider awareness of the significance of Hepatitis screening and HIV prevention.
A Sexual Wellness Screening Tool was developed and integrated into the EPIC My Chart system. The screening tool is answered by patients ahead of an initial/annual appointment through the patient portal and updated annually.
Patients with high-risk responses trigger an EPIC Best Practice Alert (BPA). The BPA recommends elements of care and prepopulates a Hepatitis B lab orders and/or referrals to the HIV prevention team. For provider buy-in and education, learning sessions were held across the network.

Results
During Q1 of 2024, 866 patients completed the tool, 525 patients screening positive for risk factors. Of the 525 patients, 88% reported having sex without a condom in the past 12 months. 65% of patients had multiple risk factors. All patients at risk, were offered testing, however 26 HBV tests were actually ordered and 5 completed. For HIV prevention, 26 referrals were generated and contacted by Prevention Navigators, leading to 2 patients beginning PrEP.
Risk Responses

Conclusion
Having patients fill out the tool ahead of appointments allows for a provider to review the tool with the patient and can help guide the conversations patients and providers have; maximizing the finite time providers have with patients and empowering patients to have their questions answered. Continued education and laboratory process refinement are necessary to streamline the work.

Disclosures
All Authors: No reported disclosures
P-536. Real-world Virologic and Safety Outcomes in People Living with HIV-1 Using Dolutegravir (DTG) + Lamivudine (3TC) in Asia Stratified by Viral Load (VL), Including in Individuals with High VLs
Authors: Doblado-Maldonado Andrés , Reen Ooi Adrian Yit , Chen Jun , Letang Emilio 
Published: January 2025

Abstract

Background
DTG + 3TC was effective for achieving virologic suppression (VS) in ART-naive adults living with HIV-1 with VL ≥ 100,000 c/mL in the GEMINI-1/-2 and STAT trials. Guidelines recommend DTG + 3TC as first-line ART in people with VL &lt; 500,000 c/mL, but in real-world settings, people have initiated this regimen with higher VLs. To support treatment decisions, we summarize real-world evidence for DTG + 3TC in ART-naive people with high VL in Asia.

Methods
Databases and congresses were searched (Jan 2013-Mar 2023) for non-interventional studies of DTG + 3TC use in N ≥ 10 people. Post hoc targeted searches were done to add recent (to Dec 2023) and non-English studies. Publications were screened for effectiveness/safety in ART-naive individuals in Asia, stratified by baseline (BL) VL. Results were summarized using lead study data by cohort to avoid overlap. High VL was ≥ or &gt; 100,000 c/mL and very high VL ≥ or &gt; 500,000 or 1,000,000 c/mL.

Results
Of 283 publications, 21 were included, with ART-naive people using DTG + 3TC in China (n=551, 6 cohorts) and Türkiye (n=56, 1 cohort). Median age ranged from 37 to 66.5 years; 59% to 93% were male. When lead study n/N were pooled by VL, 149/262 (57%) people had high VL and 147/353 (42%) had very high VL (≥ 500,000 c/mL, 113/353; ≥ 1,000,000 c/mL, 40/152) at BL. VS (primarily VL &lt; 50 c/mL) rates in lead studies in people with VL ≥ 100,000 vs &lt; 100,000 c/mL were 52% vs 64% at Week (W)4 and 60% vs 93% at W12; corresponding rates in those with VL ≥ 500,000 vs &lt; 500,000 c/mL were 5% vs 20% and 50% vs 75%. W48 VS rate was 92% for high VL (1 study; all had VL &gt; 100,000 c/mL) and ranged from 64% to 96% for very high VL (vs 90%-92% with VL &lt; 500,000 c/mL; 3 studies). In 1 study, 2 people with high VL had virologic rebound at W48 (resuppressed at W72). Outcomes were generally consistent between lead and non-lead within-cohort studies. One virologic failure was reported in a person with very high VL, due to non-adherence. Studies reported no discontinuations (n=1) or no discontinuations due to adverse events (AEs; n=7), drug-related AEs (n=1), or drug-related serious AEs (n=1). Few serious AEs occurred.

Conclusion
Similar to clinical trials, real-world evidence in ART-naive individuals initiating DTG + 3TC in Asia demonstrated high VS rates and favorable safety outcomes, even when VL was high or very high at ART initiation.

Disclosures
Andrés Doblado-Maldonado, PhD, GSK: Stocks/Bonds (Public Company)|ViiV Healthcare: Employee Adrian Yit Reen Ooi, MBBS, MS, GSK: Stocks/Bonds (Public Company)|ViiV Healthcare: Employee Emilio Letang, MD, MPH, PhD, GSK: Stocks/Bonds (Public Company)|ViiV Healthcare: Employee
P-554. Anxiety and Depression are Associated with Poor Antiretroviral Adherence in People Living with HIV: A Real-World Survey in Europe
Authors: Hennessy Fritha , Ambler Will , Holbrook Tim 
Published: January 2025

Abstract

Background
High adherence to antiretrovirals (ARV) is vital for people living with HIV (PWH) to ensure undetectable viral load and prevent viral transmission. Various factors can affect adherence, including mental health, although little is known about the impact of anxiety and depression in Europe. Therefore, we aimed to assess adherence to ARV based on PWH’s self-reported level of anxiety or depression.Figure 1.PWH response to “How often do you forget to take your ARV because…”

Methods
Data were drawn from the Adelphi HIV Disease Specific Programme™, a real-world, cross-sectional survey with retrospective medical chart data collection of PWH in Europe (France, Germany, Italy, Spain, United Kingdom) between November 2022 and June 2023. PWH self-completed surveys, reporting ARV adherence via the Adelphi Adherence Questionnaire (ADAQ), a 0 to 4 scale, with lower scores indicating greater adherence. Analyses were descriptive.

Results
Of the 501 PWH included, mean (standard deviation, SD) age was 42.2 (13.8) years and 74% were cisgender male (Table 1). PWH (n=482) self-reported being not (ND, n=226), mildly (MD, n=147), or moderately/severely/extremely (ED, n=109) anxious or depressed. PWH with ED had a notably low mean CD4+ count (Table 2). Levels of viral suppression ranged from 75.5% of MD PWH to 54.2% of ED. Worrying about forgetting to take HIV medication was reported by many ED and MD PWH. These PWH also reported that taking their ARV was an uncomfortable reminder of their HIV status (Table 3).
PWH with MD and ED had a mean (SD) ADAQ score of 0.28 (0.37) and 0.38 (0.50), respectively, compared to 0.20 [0.31] for ND. ED PWH reported lack of adherence due to being in a different routine (48%), of not wanting others to see them taking it (39%), or side effects (23%), this was 39%, 29%, 18% for ND PWH (Figure 1).

Conclusion
Anxiety and depression impact PWH’s adherence to their treatment. Higher levels of anxiety and depression are associated with low treatment adherence in PWH. Suitable mental health support, or other targeted support for PWH with anxiety or depression, may improve adherence and outcomes.

Disclosures
Fritha Hennessy, PhD, Adelphi Real World: Employee|ViiV Healthcare: The Adelphi Real World Disease Specific Programme is wholly owned by Adelphi Real World; ViiV healthcare is one subscriber and paid for the analysis Will Ambler, PhD, Adelphi Real World: Employee|ViiV Healthcare: The Adelphi Real World Disease Specific Programme is wholly owned by Adelphi Real World; ViiV healthcare is one subscriber and paid for the analysis Tim Holbrook, BSc, Adelphi Real World: Employee|ViiV Healthcare: The Adelphi Real World Disease Specific Programme is wholly owned by Adelphi Real World; ViiV healthcare is one subscriber and paid for the analysis
P-557. Weight Change After Switching from Bictegravir/emtricitabine/tenofovir alafenamide in Persons Living with HIV: A Retrospective Cohort Study
Authors: Abdessamad Hilal , Kurop Margaret , McKelvy Jane , Dandachi Dima 
Published: January 2025

Abstract

Background
Antiretroviral Therapy (ART) has revolutionized the management and outcomes of persons with HIV (PWH). However, ART has undesirable effects such as weight gain, that lead to non-compliance or medication switch. The combination Bictegravir (BIC)/emtricitabine (FTC)/tenofovir alafenamide (TAF) has been associated with weight gain, though most of the data regarding this is not comprehensive.Figure 1:Study Flowchart

Methods
A retrospective cohort study was performed on 125 patient records to assess the changes in weight, lipid panel and glycosylated hemoglobin (HBA1C) measurements in PWH who were taking BIC/FTC/TAF for at least 1 year then switched to a different combination, compared to those who remained on this regimen, over a period of 3 years (Figure 1).
Table 1
M: Male, DMII: Type 2 Diabetes Mellitus, DL: Dyslipidemia, GLP-1: Glucagon-like Peptide-1, VL: Viral Load, NA: Not Applicable

Results
Out of the 125 records reviewed, 98 (78%) continued BIC/FTC/TAF for 3 years and 27 (22%) were switched to another combination after 1 year, whether cabotegravir/rilpivrine (69%), dolutegravir/lamivudine (18%) or others (13%). The 2 groups had similar baseline mean age, sex, race, metabolic profile, viral load and CD4 counts (Table 1). There was a median weight gain of 1.3 kg after 1 year of treatment with BIC/FTC/TAF. By year 2, there was a median weight loss of 0.8kg in the group who continued the same ART and 0.2 kg in the group who switched treatment (p=0.441). However, by year 3, there was a median weight gain of 0.5 kg in those who continued the same ART and 0.2 kg in those who switched to another combination; p=0.477 (Figure 2). 25/98 (25%) patients who kept same ART experienced weight loss after 2 years, in comparison to 9/26 (34%) of patients who switched treatment (p=0.497). Low-density lipoprotein and HBA1C readings had minimal mean variations between the 2 groups.Figure 2:Change in median weight between the two patient groups after a 3-year follow-up.

Conclusion
Our data, although of small sample size, shows that while there appears to be no significant weight change while continuing BIC/FTC/TAF as compared to switching to a different regimen. Hence, switching to treatment combinations did not result in weight loss or lower LDL and HBA1C levels. To our knowledge, this is among the few studies to provide real world data on weight change after switching from B/FTC/TAF, which highlights its significance.

Disclosures
Dima Dandachi, MD, MPH, Gilead Sciences: Grant/Research Support|ViiV Healthcare: Grant/Research Support|ViiV Healthcare: Honoraria
P-568. Transmitted Drug Resistance to Antiretroviral Therapy in Chile: Preliminary Results from a Cross-Sectional Study
Authors: Ceballos Maria Elena , Ruiz-Tagle Cinthya , Castañeda Felipe , Ferrés Marcela , Palma Carlos , de Landa Angelica Domínguez , Espinoza Manuel , Afani Alejandro , Balcells María Elvira 
Published: January 2025

Abstract

Background
The use of antiretroviral therapy (ART) has reduced HIV morbi-mortality and its transmission. However, treatment failure can occur when acquiring a strain with mutations conferring resistance to antiretrovirals. Transmitted resistance to antiretroviral drugs (TDR) reported nationally was 10.45% in 2018 and is increasing worldwide. We aimed to determine the percentage of global TDR and the relevance of incorporating the genotyping study in naïve people living with HIV in Chile.

Methods
Observational, cross-sectional study conducted in 11 healthcare centers located in 7 regions of Chile. Individuals ≥18 years old with an HIV diagnosis in the last 12 months and without prior ART were invited to participate. Individuals with an HIV viral load &lt; 1000 ARN copies/mL were excluded. ARN genotyping of the reverse transcriptase, protease and integrase genes were carried out using a nested PCR with subsequent Sanger sequencing. The percentage of individuals with TDR was determined and mutations associated with TDR were identified according to the HIV Drug Resistance Database, Stanford University.

Results
Between February 2023 and April 2024, 117 participants have been sequenced (final sample size 164). The average age is 35.2 years (18-78), with 90.6% belonging to the Chilean population. 87.2% are male, of which 74.4% have sex with men. Most common viral strain was subtype B (70.1%). Overall TDR (TDR to any ART family) was 17.9% (n=21). TDR for each family and mutations are shown in Table 1 and Figure 1. In addition, other mutations were found, but they were not included in the percentage for TDR because they are not in WHO TDR list (Table 2). Three participants presented resistance to more than one ART family; one to NRTI and NNRTI, one to NRTI and INSTI and one to NNRTI and INSTI.

Conclusion
In Chile, an increase is observed in the percentage of TDR to ART compared to what has been historically reported. The main families affected are the NNRTIs and the INSTIs (mostly first generation). Considering these preliminary results, it is considered pertinent to incorporate the baseline genotyping study in patients starting ART with both NNRTI efavirenz or rilpivirine and first-generation INSTI.

Disclosures
All Authors: No reported disclosures
P-569. Changes in lipid profile in people living with HIV on stable protease inhibitors (PIs)-based regimens as second-line ART regimens switch to dolutegravir (DTG)-based regimens
Authors: Kiatkangwanchon Natthapol , Sophonphan Jiratchaya , Avihingsanon Anchalee , Gatechompol Sivaporn , Putcharoen Opass 
Published: January 2025

Abstract

Background
Antiretroviral therapy (ART) for human immunodeficiency virus (HIV) infection is associated with metabolic changes, including dyslipidemia and cardiovascular risk. Switching from protease inhibitor (PIs)-based regimens to dolutegravir (DTG)-based regimens offers potential benefits, but its impact on metabolic parameters requires investigation. This study aimed to assess the change in low-density lipoprotein cholesterol (LDL-C) levels, a risk factor for cardiovascular disease, in people living with HIV (PLWH) who switched from stable PIs-based second-line ART regimens to DTG-based regimens.Table 1Baseline characteristics of participants

Methods
We conducted a prospective cohort study evaluating lipid profile, renal function, and other metabolic parameters in PLWH who switched from PIs-based to DTG-based regimens. The DTG-based regimens comprised two nucleotide reverse transcriptase inhibitors (NRTIs), specifically tenofovir alafenamide (TAF) and emtricitabine (FTC), along with DTG in a single-tablet regimen once daily. The study was conducted at HIV-NAT, and data were collected over 24 weeks.Table 2Comparison of BMI and laboratory tests between PIs-based and 24 weeks after switching to DTG-based regimens

Results
Among 144 PLWH participants, switching to DTG-based regimens resulted in significant reductions in triglycerides (TG) and improvements in high-density lipoprotein cholesterol (HDL-C), while LDL-C and total cholesterol (TC) remained stable. Post-switching, participants experienced weight gain and increases in body mass index (BMI). Renal function, assessed by estimated glomerular filtration rate (eGFR), showed a decline. Despite these changes, virological suppression was maintained, and depressive symptoms remained stable. Notably, depression scores assessed using the Patient Health Questionnaire-9 (PHQ-9) at 24 weeks post-switching primarily indicated normal (68.3%) and mild depression (19.8%), with only one participant reporting severe depression.

Conclusion
Switching to DTG-based regimens in PLWH offers benefits in lipid profile and pill burden reduction, with modest increases in weight and LDL-C attributed primarily to the transition from TDF to TAF. Further research is needed to assess long-term effects, particularly on renal function and cost-effectiveness in diverse settings. These findings contribute to optimizing HIV care and treatment strategies globally.

Disclosures
All Authors: No reported disclosures
P-606. A Single-round Infectious Virus with Codon-deoptimized Genome: A Powerful Tool for Regulating Pathogenicity of WT/Live-Attenuated Viruses
Authors: Noguchi Takafumi , Miyamori Anju , Sugimoto Takeshi , Miyazato Paola , Sasaki Ryo , Komatsu Sayuri , Ebina Hirotaka 
Published: January 2025

Abstract

Background
Coxsackievirus B3 (CVB3) is a ssRNA(+) virus of the Picornaviridae family associated with myocarditis and type I diabetes. Prevention of mother-to-child transmission is important, especially since the outcomes of neonatal infection can be fatal. However, vaccines have not yet been developed. In this study, we revealed that CVB3 codon-deoptimized in the nonstructural proteins’ region (CVB3cd) can be used as live-attenuated vaccines (LAVs). Furthermore, we showed that in co-infection experiments, a CVB3cd-based single-round infectious virus induces interference, significantly reducing the pathogenicity of viruses.

Methods
CVB3cd were designed to be enriched in CpG-containing rare codons in the 3CD region of the viral genome. Viral proliferation was evaluated based on plaque size and growth curve; and their pathogenicity in mice was determined by weight loss and survival after infection. Defective viral particles (DVPs) were generated by packaging WT or CVB3cd replicons with a trans-expressed viral capsid protein. To evaluate the effect of viral interference with DVPs, WT or CVB3cd were co-administered with the DVPs, and their pathogenicity in mice was monitored.

Results
A decrease in viral replication was observed in correlation with the number of deoptimized codons, in addition to an increase in the survival rate of animals infected with the codon-deoptimized viruses. Among vaccination methods, intramuscular injection of the attenuated virus emerged as the least pathogenic option, effectively inducing neutralizing antibodies and providing protection against challenge by the WT virus. In addition, simultaneous infection of CVB3 with DVPs revealed that CVB3cd replicon-based DVP (DVPcd), reduced the pathogenicity of CVB3 in mice and improved the safety of LAVs without compromising immunogenicity.

Conclusion
Our data suggest that viral pathogenicity can be modulated by a combination of codon-deoptimization, route of administration, and viral interference. This approach could be a powerful strategy to develop effective and safe LAVs in a short period of time. Moreover, DVPcd could be used as therapeutic tools against viruses due to their efficient virus-interfering effects.

Disclosures
Anju Miyamori, Master of Medicine, The research foundation for microbial diseases of Osaka university: Grant/Research Support Hirotaka Ebina, Doctor of Medicine, The research foundation for microbial diseases of Osaka university: Grant/Research Support
P-621. The association between pediatric vaccine-limiting and non-completion of the combined 7-vaccine series among US military families, 2010–2019
Authors: Burrell Monica , Romano Celeste , Bukowinski Anna , Hall Clinton , Gumbs Gia , Conlin Ava Marie , Ramchandar Nanda 
Published: January 2025

Abstract

Background
Recent work reported gaps in completion of the pediatric combined 7-vaccine series among US military families. To determine the role of vaccine hesitancy as a contributing factor to undervaccination, we examined the prevalence of vaccine-limiting patterns and measured the association between these patterns and vaccine non-completion.

Methods
Department of Defense Birth and Infant Health Research program data were used to identify children born at military facilities, 2010–2019. Immunizations were identified through age 2 years using vaccine administered and Current Procedural Terminology codes from military facility immunization records and health care encounter records, respectively. Consistent vaccine limiters received &lt; 3 antigens at each vaccine visit (ie, all limited visits). Episodic vaccine limiters had ≥1 limited vaccine visit and only 3 visits with ≥3 antigens. Non-limiters had no limited visits or ≥4 visits with ≥3 antigens. Modified Poisson regression models estimated associations between vaccine-limiting patterns and non-completion of the combined 7-vaccine series by age 2 years.

Results
Overall, 271,510 children were identified for analysis. The prevalence of consistent vaccine-limiting was 0.3% (n=758); episodic vaccine-limiting was 13.6% (n=36,879). Each group was disproportionately represented among the population non-complete for the 7-vaccine series (1.1% and 27.5%, respectively). Consistent vaccine limiters had 5.6 (95% confidence interval [CI]: 5.5-5.7) times the risk and episodic vaccine limiters had 3.0 (95% CI: 2.9-3.0) times the risk of non-completion compared with non-limiters.

Conclusion
Although few US military families consistently limited pediatric vaccinations, episodic vaccine-limiting throughout the first 2 years of life was common, and both vaccine-limiting patterns were associated with higher risk for vaccine series non-completion. Findings suggest greater attention to vaccine-limiting is needed in this population.

Disclosures
All Authors: No reported disclosures