14th International AIDS Conference Barcelona, Spain — July 7-12, 2002

Int Conf AIDS. 2002 Jul 7-12;14:Abstract No. WePeB5968

BACKGROUND: Limited data suggest that women have a lower initial viral load (VL) and a more rapid response to HAART. We compared the response to HAART and toxicity in women and men treated at an inner city HIV clinic in the US.

METHODS: Retrospective matched cohort study of patients on HAART between 5/96 and 10/01 with at least 2 years of follow-up and no prior exposure to PI or NNRTI. Women were selected randomly from clinic records and matched with men (1:2) by age, race, baseline CD4 count and HCV status. Comparisons were made with stratified analysis and paired t-test. Conditional logistic regression analysis was performed to determine response to HAART (undetectable viral load at 24 months), and generalized estimating equations (GEE) to determine the relationship between the change in viral load (VL) with other covariates.

RESULTS: 222 patients (74 women, 148 men) were evaluated: 84% were black, 27% had CD4 <50, and 20% had HCV infection. There were no significant gender differences with regard to prior exposure to NRTI, years since HIV diagnosis, or mode of transmission. After 2 years of HAART, 34/74 (45.9%) women and 72/148 (48.6%) men (p=ns) had an undetectable VL. There was no difference in the number of opportunistic infections, changes in CD4 count, VL, or BMI, percent of patients undetectable after first HAART regimen or non-adherence; however, women had significantly higher rates of neurologic complications (12.6% vs. 8.0%, p<0.01) and lipodystrophy (10.8% vs. 2.0%, p<0.01). Non-adherence was associated with a detectable VL at 2 years (OR=4.44, 95% CI 2.18- 9.04, p<0.0001). Non-adherence and prior exposure to NRTI were linearly associated with change in VL (p=0.018 and p=0.011, respectively).

CONCLUSIONS: In this study gender did not affect response to HAART. The incidence of lipodystrophy and neurologic disorders were significantly higher in women.

Presenting author: Minh Ly Nguyen

1Emory University/Grady Health Systems, Decatur, GA, United States.

2BIH/Harvard University, Boston, MA, United States.

3Emory University/CFAR, Atlanta, GA, United States.

4Grady Hospital, Atlanta, GA, United States.

5Emory University/Grady Health system/CFAR, Atlanta, GA, United States.

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Copyright © 2002 - International AIDS Society (IAS). Reproduction of this abstract (other than one copy for personal reference) must be cleared through the IAS.