Abstract Details

Title Association of Sex With Cerebral White Matter Disease in People With HIV Infection

Topic Infectious Disease

Presentation(s) S9 - Neuroinfectious Disease: Associations and Outcomes (4:30 PM-4:42 PM)

Poster/Presentation
Number 006

Objective To compare white matter disease (WMD) burden between female and male participants with HIV (PWH) from the SEx differences in MechANisms of impaired cogniTIon in the MACS/WIHS Combined Cohort Study (SEMANTICCS).

Background PWH have a high prevalence of cerebral WMD despite viral suppression on antiretroviral therapy (ART). Women with HIV, who are at elevated risk of clinical stroke events, may also be more susceptible to subclinical WMD on MRI.

Design/Methods Participants on ART at moderate to high cardiovascular disease (CVD) risk were enrolled at 3 U.S. sites and underwent brain MRI. A radiologist blinded to clinical data assigned Fazekas score based on visual rating of WMD, ranging from 0 (no WMD) to 3 (severe WMD). We constructed linear regression models adjusted for demographics, CVD and other factors to assess the association of sex with log-transformed WMD.

Results Among 151 participants, 55% were female, median age was 58 years, and median viral load was <20 copies/mL. The distribution of race/ethnicity differed by sex (57% Black, 17% White, 11% Hispanic female participants vs. 22% Black, 47% White, 18% Hispanic male participants, p<0.001). Female participants were more likely to be current smokers (37% vs 19%, p=0.04), and to have higher BMI (31.8 vs. 28.8 kg/m2, p=0.01) and more depressive symptoms (Center for Epidemiologic Studies Depression Scale score 14 vs 9, p=0.018). No difference was observed in diabetes prevalence or use of anti-hypertensive or cholesterol-lowering medications. Female sex was associated with greater burden of WMD (176%, 95% CI 20%-537%, p=0.017), independent of age, race/ethnicity, CVD and other factors, including those that differed by sex.

Conclusions Among PWH, female individuals may have a higher burden of subclinical WMD than male individuals, which is not explained by differences in demographics or CVD risk factors. Research is needed to identify drivers of elevated cerebrovascular risk in women with HIV.

Authors/Disclosures
Natalie Neale, MD (UCSF) PRESENTER	Dr. Neale has nothing to disclose.
YIYI MA	Dr. MA has nothing to disclose.
Yannan Yu, MD (UCLA)	Dr. Yu has nothing to disclose.
Mackenzie Vogan, MPH	Miss Vogan has nothing to disclose.
Jennifer Sullivano, RN, NP	Mrs. Sullivano has nothing to disclose.
Anastasia Polos, MPH	Ms. Polos has received personal compensation for serving as an employee of UCSF.
Stephen Gange, PhD	The institution of Prof. Gange has received research support from NIH.
Catalina Ramirez	The institution of Prof. Ramirez has received research support from NIH.
Claudiu Schirda, PhD (University of Pittsburgh School of Medicine)	Dr. Schirda has nothing to disclose.
Ling Lin, MD, PhD	Dr. Lin has nothing to disclose.
Michelle Floris-Moore, MD	Dr. Floris-Moore has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for ViiV Healthcare.
Phyllis Tien, MD	The institution of Dr. Tien has received research support from Merck. The institution of Dr. Tien has received research support from NIH. Dr. Tien has received publishing royalties from a publication relating to health care.
Bernard J. Macatangay, MD	The institution of Dr. Macatangay has received research support from Merck.
Jared Narvid	No disclosure on file
Felicia Chow, MD (Zuckerberg San Francisco General Hospital)	Dr. Chow has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Medicolegal consulting. The institution of Dr. Chow has received research support from NIH.

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