Editorial Board - Infection & Chemotherapy

Editorial Board

Editor-in-Chief

Dong-Gun Lee

The Catholic University of Korea, Korea

Associate Editors

Byung Chul Chun

Korea University, Korea

Dae Sun Jo

Chonbuk National University, Korea

Baek-Nam Kim

Inje University, Korea

Heejung Kim

Yonsei University, Korea

Sun Hee Lee

Pusan National University, Korea Kyoung Un Park

Seoul National University, Korea

Wan Beom Park

Seoul Natoinal University, Korea

Eui-Cheol Shin

KAIST, Korea

Editorial Board

Yagob Al-Mazrou Saudi Health Council, Saudi Arabia

Lucille Blumberg National Institute for Communicable Diseases, South Africa

Yi Ann Louis Chai National University Health System, Singapore

Mee Soo Chang Seoul National University, Korea Remi Charrel Aix-Marseille University, France

Yee-Chun Chen National Taiwan University, Taiwan

Hee Jin Cheong Korea University, Korea

Hee Jung Choi Ehwa Womans University, Korea

Min-Ho Choi Seoul National University, Korea

Sang-Ho Choi University of Ulsan, Korea

Young Hwa Choi Ajou University, Korea

Doo Ryeon Chung Sungkyunkwan University, Korea

Benjamin Cowie WHO Collaborating Centre for Viral Hepatitis, Australia

Byung Wook Eun Eulji University, Korea

Nohynek Hanna National Institute for Health and Welfare, Finland

Sue Huang Institute of Environmental Science and Research, New Zealand Eung-Soo Hwang Seoul National University, Korea

Youngmee Jee Korea Center for Disease Control and Prevention, Korea

Joseph F John, Jr Medical University of South Carolina, USA

Bum-Joon Kim Seoul National University, Korea

Hong Bin Kim Seoul National University, Korea

Nam Joong Kim Seoul National University, Korea Ichiro Kurane National Institute of Infectious Diseases, Japan

Hyuck Lee Dong-A Medical Center, Korea

Sang-Oh Lee University of Ulsan, Korea

Anna Lena Lopez University of the Philippines, Philippines

Moon H. Nahm University of Alabama at Birmingham, USA

John M Nicholls Hong Kong University, China

Hyunjoo Pai Hanyang University, Korea

Kyong Ran Peck Sungkyunkwan University, Korea

Raymund R. Razonable Mayo Clinic, USA

Jeong Hwan Shin Inje University, Korea

Adebayo Shittu Obafemi Awolowo University, Nigeria

Robert Leo Skov Statens Serum Institut, Denmark

Joon Young Song Korea University, Korea

Young Goo Song Yonsei University, Korea

Vincent H. Tam University of Houston, USA

Tomohiko Takasaki Kanagawa Prefectural Institute of Public Health, Japan

Visanu Thamlikitkul Mahidol University, Thailand

Thomas J. Walsh Weill Cornell Medicine of Cornell University, USA

Eun Jeong Won Chonnam National University, Korea

Statistics Editor Jun-Pyo Myong The Catholic University of Korea, Korea

Manuscript Editor Ji Hee Lee [email protected]

The Korean Society for AIDS

2020 대한에이즈학회 학술대회

Vol. 52 • Sup3 • November 2020

Aims and Scope

Infection & Chemotherapy (Infect Chemother) is an international, peer-reviewed, and open-access journal in English, which pub-

lishes the current research on issues posed by infectious diseases worldwide. This journal, which is published quarterly (on the last

day of March, June, September, and December) in both print and online (https://icjournal.org) versions, is the only official pub-

lication of the Korean Society of Infectious Diseases, Korean Society for Antimicrobial Therapy, and the Korean Society for AIDS.

It publishes review articles, original articles, brief communications, correspondences, case reports, editorials, and special articles

covering an extensive range of clinical descriptions on infectious diseases, public health issues, microbiology including emerging

resistance, parasitology and immunity to microbes, current and novel treatments, and the promotion of optimal practices or guide-

lines for diagnoses and treatments. As the world continues to shrink as a result of globalization, it is necessary that appropriate

communication is maintained among countries for timely sharing of information on infectious diseases. This is an important topic

because such diseases tend to have unique biologic features according to the regions in which they develop, and these diseases can

easily become niduses that may spread globally at any time. Based on these factors, the aim of this publication is to facilitate com-

munication among societies and countries, enabling the worldwide sharing of information on infectious diseases. The scope of this

journal is to link basic and clinical research in the field of infectious diseases, in reference to relevant evidence. The journal con-

tinuously attempts to publish current global and regional topics concerning infectious diseases and their diagnoses and manage-

ments to create awareness of related issues and link various developing and developed countries.

• Manuscripts of articles for publication should be submitted online through the Infection & Chemotherapy e-submission system

at http://www.editorialmanager.com/ic

• Open Access, everyone everywhere can read your research without cost.

• Full text PDF files are available at https://www.icjournal.org

• Infection & Chemotherapy is indexed/tracked/covered by Emerging Sources Citation Index (ESCI), PubMed, PubMed Central,

SCOPUS, CrossRef and DOI, DOAJ, EMBASE, CAS, Google Scholar, CABI, KoreaMed, Synapse, KoMCI.

• It has been published since 1969.

Editor in Chief Dong-Gun Lee

Editorial Office#806, Seocho Town Trapalace, 23 Seocho-daero 74-gil, Seocho-gu, Seoul 06621, Korea Tel. +82-2-532-6003 / Fax. +82-2-535-2494 / E-mail. [email protected] / Web. https://icjournal.org

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This journal was supported by the Korean Federation of Science and Technology Societies Grant funded by the Korean Government

(Ministry of Education).

© Infection & Chemotherapy◯CC It is identical to the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0).

◯CC This paper meets the requirements of KS X ISO 9706, ISO 9706-1994 & ANSI/NISO Z.39.48-1992 (Permanence of Paper)

E-poster session분야 발표번호 제목 발표자 Page

Basic and translational research

P-01Comparison of T cell subsets between virally-suppressed HIV-infected

patients receiving antiretroviral therapy and normal control김윤정 / 253


P-02

Potassium acetate alleviates HIV-1 Tat-induced pro-inflammatory

chemokines expression by suppressing the HDAC6-ROS-MAPK-NF-kB

axis in astrocytes

윤기수 / 254


P-03Improvement of latent HIV-1 infection model by blocking pyroptosis-

mediated cell death김동은 / 255


P-04

Construction and examination of a new type of Brec1

Recombinase derivatives for the Elimination of HIV Proviral DNA

from the Host Genome

배준현 / 256


P-05The novel biological function of FBXW4 in Human

Immunodeficiency Virus Type-1 (HIV-1) replication유경리 / 257


P-06Aristolactam derivatives against Human Immunodeficiency

virsus-1 with inhibition of Tat-mediated viral transcription신영현 / 258


P-07Enhanced Anti-viral effect of SCOTIN derivatives on Human

Immunodeficiency Virus-1(HIV-1) production김가나 / 259


P-08Ack1, a novel Nef binding partner, play a key role in CD4

down-regulation by HIV-1 infection김정아 / 260


P-09Discovery of Effective HIV-1 Transcription Inhibitory Antiviral

Peptides김해인 / 261


P-10

Sequence length of HIV-1 subtype B increases over time: a

longitudinal analysis of a Korean hemophiliac cohort over 30

years

조영걸 / 262

Clinical research P-11Age at which subclinical atherosclerosis occurs in people living

with HIV in Korea박성희 / 263

Clinical research P-12

Evaluation of lipid profile in HIV patients on dolutegravir,

abacavir, lamivudine, and elvitegravir, cobicistat, emtricitabine,

tenofovir alafenamide - a single center clinical experience

배상운 / 264

Clinical research P-13Rate of and risk factors for loss to follow up in HIV-infected

patients in South Korea: Korean HIV/AIDS cohort study성 혜 / 265


Integrase strand transfer inhibitor treatment does not increase

the incidence of immune reconstitution inflammatory

syndrome in HIV-infected Koreans

김 진 / 276

Clinical research P-15Lenacapavir Resistance Analysis in a Phase 1b Clinical Proof-Of-

Concept Study이정아 / 277



분야 발표번호 제목 발표자 Page

Clinical research P-16 코로나19가 감염인 상담에 미치는 영향 : case study 서아영 / 278


Starting or switching to bictegravir/emtricitabine/tenofovir alafenamide

(B/F/TAF) in clinical practice: pooled 12-month (12M) results from

the global BICSTaR study

이정아 / 280


Durable Efficacy of Dolutegravir (DTG) Plus Lamivudine (3TC)

in Antiretroviral Treatment-Naïve Adults With HIV-1 Infection

–3-Year Results From the GEMINI Studies

권성신 / 281

Clinical research P-19Safety and Efficacy of Cabotegravir + Rilpivirine Long-Acting

With and Without Oral Lead-In: FLAIR Week 124 Results권성신 / 283

Clinical research P-20 HIV 감염자에서 발생한 항문암 4례와 인간유두종바이러스와의 관련성 백예지 / 286


Pooled Analysis of 4 International Trials of Bictegravir/Emtricitabine/

Tenofovir Alafenamide (B/F/TAF) in Adults Aged ≥ 65 or Older

Demonstrating Safety and Efficacy: Week 48 Results

이정아 / 289


Switching to DTG/3TC Fixed-Dose Combination (FDC) Is Non-Inferior

to Continuing a TAF-Based Regimen (TBR) in Maintaining Virologic

Suppression Through 96 Weeks (TANGO Study)

권성신 / 290

Epidemiology and social research

P-23

Assessment of disease burden and immunization rates for

vaccine- preventable diseases in people living with HIV: The

Korea HIV/AIDS Cohort study

성 혜 / 292


P-24의료기관감염인상담사업 지표로 본 감염인 건강관리 현황 : 2015년~2019

년 시계열 분석최재필 / 301


P-25 남성 동성애자 대상 성 건강 결정 영향요인 양혜진 / 303


P-26

Stuck in Neutral: Identifying opportunities to make progress in

addressing HIV-related stigma and other emotional and

psychosocial unmet needs among people living with HIV in

South Korea

권성신 / 304

E-poster session

2020The Korean Society for AIDS

대한에이즈학회 학술대회

E-poster session

2020 대한에이즈학회 학술대회 253

P-01 Basic and translational research

Comparison of T cell subsets between virally-suppressed

HIV-infected patients receiving antiretroviral therapy and

normal control

Youn Jeong Kim , Si-Hyun Kim , Yeon Jeong Jeong , Yoon Hee Jun , Sang Il Kim , Yang Ree Kim

Division of Infectious disease, Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Korea

Introduction: With the introduction of antiretroviral therapy (ART), the majority of HIV-infected

individuals fully suppress viral load and display a progressive increase in CD4 counts resulting in

improvement in their health. However HIV infection results in changes T cell phenotype and function

which may persist even during effective ART. The aim of this study was to determine profiles of T cells

in virally suppressive HIV-infected patients after ART.

Methods: We included HIV-infected subjects receiving ART with VL<40 copies/mL for at least one year,

and compared with healthy control. Selected panels of immunological markers of T were evaluated by

flow cytometry.

Results: Nineteen HIV-infected patients and twenty-five healthy controls were included. The mean age

was 44.8±14.6 years among the HIV-infected and 61.3±5.2 years old among the control (p=0.0001).

HIV-infected subjects had a mean duration of viral suppression of 2759.8±2139.7 days prior to

enrollment). The mean CD4+ count at the time of enrollment was 639.1±153.7 cells/mm3

The proportion of CD4+ CD161+ T cells (8.5±5.5 vs. 4.9±3.6, p=0.01) CD57+CD28- (0.6±0.6 vs.

0.3±0.3, p=0.04) were higher in HIV-infected group. The proportion of CD4+ CD45RA+CCR7+

(49.4±16.6 vs. 28.9±15.7, p=0.001) were higher and the proportion of CD4+ CD45RA-CCR7-

(10.2±5.6 vs. 23.1±10.3, p=0.0001) and CD45RA+CCR7- (1.8±1.4 vs. 6.9±8.0, p=0.005) were lower

in HIV-infected group.

The proportion of CD8+ CD45RA+CCR7- (29.9 ±13.5 vs. 17.9±16.0, p=0.01) were higher in

HIV-infected group.

In the analysis of subgroups over 50 years of age, the proportion of CD4+ CD28- expressing CD57+

(p=0.01) and CD8+ CD28- expressing CD57+ (p=0.009) was higher in HIV-infected group. And the

proportion of CD4+CD45RA-CCR7- was significantly lower in HIV-infected group (p=0.001).

Conclusion: Our results showed that dysfunctional phenotype including late-differentiated peripheral

blood CD4+ and CD8+ T cell may take place despite of successful ART.

Keywords: HIV, T cell, phenotype, ART



254 2020 대한에이즈학회 학술대회


Potassium acetate alleviates HIV-1 Tat-induced

pro-inflammatory chemokines expression by suppressing

the HDAC6-ROS-MAPK-NF-kB axis in astrocytes

Donggyu Kim, Hyundong Jo, Gi Soo Youn, Soo Young Choi, Jinseu Park

Department of Biomedical Science and Research Institute for Bioscience & Biotechnology, Hallym University, Chunchon 200-702, Republic of Korea

Background: HIV-1 trans-activator of transcription (Tat) activates NADPH oxidase resulting in the

generation of reactive oxygen species (ROS), leading to extensive neuroinflammation in the central

nervous system and progress to AIDS-related encephalitis or dementia. Astrocytes, the major glial cells

in the central nervous system, contribute to immune regulation by expressing chemokines, cytokines,

and adhesion molecules. This report explored potassium acetate (PA) regulatory activity on HIV-1

Tat-mediated chemokine production and its mode of action in astrocytes.

Methods: These experiments used human astrocyte cell line CRT-MG cells. HIV-1 Tat purification

followed the Glutathione S-transferase fusion protein purification method, and the GST-Tat fusion

protein was digested with thrombin to get the Tat protein. Potassium acetate was pre-treated before

HIV-1 Tat treated 1 hour.

Results: Potassium acetate significantly suppressed HIV-1 Tat-mediated production of

pro-inflammatory chemokines, such as CCL2, CXCL8, and CXCL10. Potassium acetate inhibited the

expression of HDAC6, which is an important regulator in HIV-1 Tat-mediated chemokine production.

Potassium acetate diminished HIV-1 Tat-mediated reactive oxygen species (ROS) generation and

NADPH oxidase activation. Furthermore, inhibited HIV-1 Tat-mediated signaling cascades, including the

HDAC6-ROS-MAPK-NF-kB axis.

Conclusion: Overall, these results showed that Potassium acetate regulates HIV-1 Tat-induced

pro-inflammatory mediator expression via blockage of the HDAC6-ROS-MAPK-NF-kB axis in

astrocytes. Therefore, suggest that potassium acetate is a therapeutic compound candidate against

AIDS-related encephalitis or dementia.

Keywords: HIV-1 Tat, chemokines, inflammation, HDAC6, NADPH oxidase

E-poster session



Improvement of latent HIV-1 infection model by blocking

pyroptosis-mediated cell death

Dong-eun Kim, Cheol-Hee Yoon, Young Hyun Shin, Byeong-Sun Choi

Division of Chronic Viral Disease Research, Center for Emerging Virus Research, National Institute of Infectious Disease, Chungbuk, Korea

Background: The highly active antiretroviral therapy (HAART) efficiently controls HIV infection and

prevents the AIDS progression, but this treatment cannot completely eliminate HIV reservoir. Several

studies developed the ex vivo models for HIV-1 latency to determine the specific characteristics of the

reservoirs. However, these models using non-replicative viruses could not represent the latent in vivo

infection. Here, we improved a primary latent HIV-1 infection model using replication-competent virus

by inhibiting pyroptosis.

Methods: Naive CD4 T cells were isolated from the PBMCs and the cells were then activated and

polarized to TCM for 7 days. After differentiation, cells were infected with replication-competent HIVNL4-3

(MOI 1). For 2 days, the infected cells were treated with inhibitors of caspase-1, capase-3 and viral

infection. At day 4, 6 and 8 post-infection, the cell viability was analyzed. At day 6 post-infection, cells

were reactivated and assessed p24 level to determine the population of latently infected cells.

Results: In an assay for cell viability, It was observed that the cell viability were markedly increased

about two fold in the cells treated with caspase-1 inhibitor compared to vehicle. At same time, latently

HIV-1 infected cells were countered using anti-p24 antibody conjugated with FITC after T cell

activation. The population of p24 positive cells was increased about two-fold in cells treated with

caspase-1 inhibitor compared to vehicle-treated cells. The enhanced p24+ cell number might be caused

by enhanced cell viability. In a LDH release assay for detecting pyroptosis, the amount of LDH released

from HIV-1 infected were definitely reduced about 40% in the cells treated with caspase-1 inhibitor.

Conclusion: Taken together, we improved the latent HIV-1 infection model using replication-competent

virus which may be helpful to define characteristics of latent HIV-1 infection.

This work was supported by Grant No. 2019-NI-067-01 from the KNIH

Keywords: HIV-1, latency model, pyrotosis, caspase-1





Construction and examination of a new type of Brec1

Recombinase derivatives for the Elimination of HIV Proviral

DNA from the Host Genome

Jun-Hyun Bae, Ji-Chang You

National Research Laboratory for Molecular Virology, Department of Pathology, School of Medicine, The Catholic University of Korea, Seoul.

Background: Even though combinatorial antiretroviral therapies (cART), which are used to treat HIV-1

infection, can effectively suppress and relieve symptoms of AIDS, but it does not completely eliminate

HIV-1 infection. In order to effectively cure HIV-1 infection, it is needed that the integrated proviral

DNA must be removed from the virus-infected host genome.

Methods: Toward the goal, We set to develop a therapeutic protein drug using Broad-range

recombinase 1 (Brec1) and a novel advanced cell-penetrating peptide (ACP). The Brec1 has previously

been known to efficiently and safely remove integrated provirus from HIV-1 infected cells. However, it

in its current form is difficult to being used as for a protein drug as it cannot get into cells by itself. To

overcome this problem, we fused the Brec1 with ACP, which can be easily internalized into cells and

might capable of targeting integrated proviral DNA in HIV-1 infected cells.

Results: We observed that the overexpression of ACP-Brec1 lead to the excision of co-transfected

proviral DNA in HIV-integrated cell lines. Virus production was also found to be significantly reduced by

HIV-1 p24 ELISA and western blot assay.

Conclusion: This novel approach using a combination of Brec1 and ACP might have a great potential to

develop a novel fundamentally curative HIV-1 therapy.

Keywords: HIV-1, Provirus

E-poster session



The novel biological function of FBXW4 in Human

Immunodeficiency Virus Type-1 (HIV-1) replication

Kyung-Lee Yu, Ji Chang You

National Research Laboratory for Molecular Virology, Department of Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea 137-701

Background: The HIV-1 nucleocapsid (NC) is an essential viral protein containing two highly conserved

retroviral-type zinc finger (ZF) motifs, which functions in multiple stages of the HIV-1 life cycle. We

have screened several host cell factors interacting with NC protein through in vitro pull-down assay and

yeast two-hybrid assay. Among them, F-box/WD repeat domain-containing protein 4 (FBXW4) was

identified.

FBXW4 is a component of SCF (SKp1, Cullin, F-box protein)-type ubiquitin ligase, which mediates

ubiquitination of proteins targeted for degradation by the proteasome. So far, no target protein has been

identified for FBXW4, and little research has been done on the molecular or biochemical function of

FBXW4.

To identify the biological function of interaction between NC and FBXW4, we confirmed the effects of

FBXW4 on HIV-1 replication.

Methods and Materials: To overexpression of FBXW4, HA tagging FBXW4 plasmid were constructed. In

293T cells, we confirmed the effect either FBXW4 overexpression or knock-down in virus replication by

measuring the HIV-1 production by p24 ELISA assay and confirmed the Gag protein expression level by

western blot. In HeLa cells, we confirmed the subcellular localization of FBXW4 under conditions of

HIV-1 expression and absence.

Results: Both overexpression and knock-down of FBXW4 reduce the virus replication. In HIV-1

expression cells, co-localization between the Gag and FBXW4 at cell plasma membrane.

Conclusions: Our data show that HIV-1 requires the FBXW4 to replication properly, but if FBXW4

becomes overloaded, it causes suppression. We are working on a study to determine the exact

mechanism of FBXW4 role in HIV-1 replication.

Keywords: HIV-1, Nucleocapsid, FBXW4,





Aristolactam derivatives against Human Immunodeficiency

virsus-1 with inhibition of Tat-mediated viral transcription

YoungHyun Shin1, Hong Gi Kim2, Chul Min Park2, Dong-Eun Kim1, Jeong-Ah Kim1, Byeong-Sun Choi1, Cheol-Hee Yoon1

1Division of Chronic Viral Disease Research, Center for New Infectious Diseases Research, National Institute of Infectious Diseases, Korea National Institute of Health, Chungbuk, Republic of Korea2Center for Convergent Research of Emerging Virus Infection, Korea Research Institute of Chemical Technology, Daejeon, 34114, Republic of Korea

Background: Despite the success of antiretroviral therapy (ART), an effort to develop new class of

anti-HIV-1 agent have been ongoing with emergence of the drug resistances. Dibenso/indole-based

aristolactams are compounds isolated from various plants species which have multiple clinically relevant

effects including anti-inflammatory, antiplatelet and anti-mycobacterial effects, but it has not been

elucidated in anti-HIV-1 effect.

Methods: In this study, aristolactam derivative bearing dibenzo[cd,f]indol-4(5H)-one showed a potent

anti-HIV-1 effect for the first time. Subsequently, the structure–activity relationship (SAR) study using

nine synthetic derivatives of aristolactam revealed that residue substitutions had different effects on

HIV-1 infection and cell viability.

Results: Among the compounds tested, the 1,2,8,9-tetramethoxy-5-(2-(piperidinyl)ethyl)-dibenzo[cd,

f]indol-4(5H)-one (ID 183341) exhibited the most potent activity by inhibiting HIV-1 infection with a

half-maximal inhibitory concentration (IC50) of 1.03 μM and CC50 of 16.91 μM (Selective index 16.45).

Their inhibitory effect on HIV-1 infection linked to inhibition of viral life cycle in the T cell lines and

PBMCs. In a sequential study for defining the mode of action, the aristolactam derivatives did not affect

the revers-transcription and integration required in HIV-1 infection, while they inhibited viral

transcription with closely similar to pattern shown in their inhibition of HIV-1 infection without

nonspecific transcriptional inhibition.

Conclusion: Taken together, these findings suggested that several aristolactam derivatives impaired

HIV-1 infection by inhibiting the activity of Tat-mediated viral transcription and these derivatives may

be considerable candidates for the development of antiretroviral agents.

This research was supported by intramural fund (Grant No. 2019-NI-066-01) from the Korea National

Institute of Health.

Keywords: Aristolactam, HIV-1 Tat, HIV-1 Transcriptional inhibitors, Anti-HIV-1 effects

E-poster session



Enhanced Anti-viral effect of SCOTIN derivatives on

Human Immunodeficiency Virus-1(HIV-1) production.

Ga-Na Kim, Kyung-Lee Yu, Ji-Chang You


Background: The cell penetration peptide (CPP) composed of typically 5-30 amino acids can be used to

improve the probability of molecular transfer, including drugs. Also, it provides the potential to increase

the therapeutic effect of the disease. Lately, Unpublished Advanced Cell Penetration-Peptide (ACP) is

studying in our laboratory has established a novel CPP, named ACP, which shows a better delivery

activity than well-known CPP such as Tat of HIV-1. In addition, we have also demonstrated that

SHISA5 gene has an anti-virus effect against HIV-1. Here, we have examined whether anti-viral

activity of SCOTIN against HIV-1 production could be enhanced and delivered by fusing the ACP.

Method: We have made expression vectors of SCOTIN and ACP fusion SCOTIN. The protein expression

level of each vector was verified by western blot assay and Fluorescence. Next, they were

co-transfected with NL4-3_GFP DNA to 293T cells, and viral production level was measured by

Western blot assay and enzyme-linked immunosorbent assay. Viral infectivity was also determined by

GFP signal. The same volume of virus-containing each culture supernatant was used to infect MT4

cells.

Results: The protein expression level of ACP-SCOTIN and SCOTIN-ACP was compared with SCOTIN.

We observed the separation of ACP and SCOTIN by a signal sequence of SCOTIN in the expression of

ACP-SCOTIN. Overexpression of each recombinant significantly reduced the p24 level than SCOTIN

alone. Also, we confirmed that the level of GFP was further reduced in the ACP fusion SCOTIN

expression. As a result, our study showed that ACP fusion form of SCOTIN inhibited and reduced

infectivity of progeny virus and production of HIV-1 quite efficiently.

Conclusion: Taken together, these results suggested that ACP could enhance the effect of anti-HIV-1

by SCOTIN. Thus, this approach might be a useful approach for the development of a new anti-HIV-1

drug molecule.

Keywords: AIDS, HIV-1, CPP, ACP, SCOTIN





Ack1, a novel Nef binding partner, play a key role in CD4

down-regulation by HIV-1 infection

Jeong-Ah kim, YoungHyun Shin, Dong-Eun Kim, Eun-ji Kim, Cheol-Hee Yoon

Division of Chronic Viral Disease Research, Center for New Infectious Diseases Research, National Institute of Infectious Diseases, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Chungbuk, Korea

Background: Nef is a key factor inducing HIV-1 virulence, which is commonly defective in HIV-1s

isolated from long term non-progressors. Numerous studies determined the virulence mechanism

underlying the molecular biology of Nef including CD4 and MHC-I/II down-regulation and increased

viral infectivity, but the detailed mechanism of Nef-induced virulence is not understood fully. Here, we

report that Ack1 is a novel Nef-interacting partner that plays a crucial role in CD4 down-regulation

during viral infection

Methods: To identify Nef binding partners, we performed yeast two hybrid method and confirmed their

interaction in 293T cells by co-immunoprecipitation (Co-IP). In order to identify the Nef binding domain

on ACK1, we constructed deleted forms of Ack1 and determined the binding domain by co-IP.

Additionally, to test whether Ack1 is a necessary factor for Nef-induced down-regulation of surface

immune molecule, shRNA knock-down of ACK1 was conducted in Tzm-bl cells expressing CD4,

CXCR4 and CCR5.

Results: We discovered 60 kinds of Nef-binding host proteins using yeast two-hybrid screening

method. Among these, TNK2, also called ACK1 (Activated Cdc42-associated kinase). In the Nef

expressing cells, the level of Ack1 mRNA was not changed, whereas the protein level was significantly

reduced. In a mapping assay, Nef specifically binds to the SH3 domain of Ack1. To determine whether

the interaction of ACK1-Nef influence on down-regulation of surface immune molecules, shRNA

knock-down of ACK1 was conducted in TZM-bl cells. The ACK1 knock-down significantly

down-regulated the expression of CD4 as well as co-receptors, similarly to shown in HIV-1 infected

cells.

Conclusion: Taken together, Nef facilitates the degradation of ACK1 protein by direct Nef-ACK1

interaction, which may trigger down-regulation of immune molecules including CD4, CCR5 and CXCR4

on the host cell surface linked to HIV-1-induced virulence.

This work was supported by Grant No. 2019-NI-066-01 from the KNIH

Keywords: Nef, ACK1, HIV-1 virulence, CD4 down-regulation

E-poster session



Discovery of Effective HIV-1 Transcription Inhibitory

Antiviral Peptides

Hae-In Kim, Ji-Chang You


Background: P-TEFb is comprised of CycT1 and CDK9, and it is required for transcription elongation for

both HIV and host gene expression. The 7SK snRNP complex not only plays an essential role in the

regulation of transcription by RNA Pol II but also regulates P-TEFb activity. One of the 7SK snRNP

components, HEXIM1, binds to P-TEFb and inhibits the cyclin-dependent kinase activity of P-TEFb by

concealing the substrate-binding site of CDK9. Viral trans-activator Tat can hijack P-TEFb from 7SK

snRNP and convey it to TAR, which induces enhanced gene expression from the HIV promoter by

engaging RNA Pol II. Recently, it has been shown that the chimeric protein HEXIM1-Tat (HT) impedes

viral transcription, by contending with Tat for TAR binding. We conducted the present research to

develop antiviral agents that could more effectively inhibit virus transcription.

Methods: We fused HT with Advanced cell-penetrating protein (ACP), a novel peptide identified and

developed in our laboratory. NL43-eGFP co-transfected with ACP-HT, HT-ACP, or HT into 293T cells.

The resulting cell lysates were used for Western blot and the supernatants were also collected for

ELISA and for infection of MT4 cells. The LTR assay was performed in the T-REx 293 cell to examine

the inhibition of viral transcription.

Results: Stable expression of ACP-HT or HT-ACP inhibited viral protein expression more effectively

than HT itself. ACP-HT and HT-ACP depleted the p24 level of the supernatant up to 95.7% and 81.3%,

while HT reduced only up to 52.2 %. Also, the expression of ACP-HT or HT-ACP induces a decrease in

virus-infected cells and LTR activity. The results suggested that ACP-HT or HT-ACP could inhibit virus

production and restrain the infectivity of the progeny virus.

Conclusion: We found the potential for the new fusion proteins to outperform the antiviral effects of HT.

These novel chimeric proteins inhibit HIV-1 replication efficiently and denote new candidates for novel

anti-HIV-1 therapy.

Keywords: HIV-1 transcription, antiviral drug, HEXIM1, Tat





Sequence length of HIV-1 subtype B increases over time:

a longitudinal analysis of a Korean hemophiliac cohort over

30 years

Young-Keol Cho, Jung-Eun Kim

Departments of Microbiology, University of Ulsan College of Medicine, Seoul, Korea.

Objective: The aim of this study was to investigate whether sequence length of HIV-1 increases over

time.

Design: A longitudinal analysis of near full-length HIV-1 sequences (FLs) in an outbreak of HIV-1

infection among Korean hemophiliacs and local controls previously identified as infected with Korean

subclade B (KSB).

Methods: Genes amplified by overlapping RT-PCR or nested PCR were subjected to direct sequencing.

One hundred twenty-five FLs were sequentially determined over 30 years in 62 KSB-infected patients.

Sequence length over time was compared with HIV Sequence Database at Los Alamos National

Laboratory.

Results: Phylogenetic analysis indicated that within KSB, two FLs from plasma donors O and P

comprised two clusters together with eight hemophiliacs and twelve hemophiliacs, respectively

(bootstrap values, all 100%). Signature pattern analysis for the KSB of HIV-1 revealed signature

nucleotide residues 1.05% (91 residues), compared with local controls. In addition, in-depth FLs

sequence analysis over 30 years in KSB indicates that the sequence length of HIV-1 significantly

increases over time before combined antiretroviral therapy (cART) and do not increase on cART.

Furthermore, the increase in sequence length over time occurred in subtypes B and C, but, suprisinlgy,

it did not occur in about 4-fold rapidly progressing subtype D. Consequently, sequence length of

subtype D was significantly shorter than all subtypes we analyzed.

Conclusion: Phylogenetic and signature pattern analysis revealed the epidemiological linkage between

plasma donors and hemophiliacs. Sequence length of HIV-1 subtypes B and C increases over time

before cART.

Keywords: full-length HIV-1, Korean subclade B; subtypes B, C and D; sequence length; hemophiliacs

E-poster session


P-11 Clinical research

Age at which subclinical atherosclerosis occurs in people

living with HIV in Korea

Sunghee Park1, Eunyoung Lee2, Se Yoon Park3, Eunjung Lee3 , Tae Hyong Kim3

1Division of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea; 2Division of Infectious Diseases, Seoul National University Boramae Medical Center, Seoul, Republic of Korea; 3Division of Infectious Diseases, Soonchunhyang University College of Medicine, Seoul, Republic of Korea

Background and Objectives: People living with human immunodeficiency virus (PLHIV) are known to

have an increased risk of atherosclerosis and cardiovascular disease (CVD). Carotid intima-media

thickness (IMT) is often measured as a surrogate marker for cardiovascular risk, but such data on Asian

PLHIV is limited. In this study, we aimed to identify the risk factors of increased carotid IMT in PLHIV

living in South Korea.

Methods: A total of 225 PLHIV who underwent carotid IMT in a teaching hospital in Seoul, Republic of

Korea between January 2017 and January 2020 were analyzed. The participants were then divided into

the subclinical atherosclerosis group and the control group. Data on clinical characteristics, underlying

diseases, laboratory findings, and antiretroviral therapy regimens, along with carotid IMT measurements

were compared between the two groups.

Results: Among the study population, 123 (54.7%) had subclinical atherosclerosis. The subclinical

atherosclerosis group was older than the control group (46 vs. 35.1 years, p<.001), had more

hypertension (33.3% vs. 19.6%, p=0.021), dyslipidemia (56.9% vs. 16.7%, p<.001), and CVD history

(6.5% vs. 0%, p=0.009). The cut-off level of age to predict subclinical atherosclerosis was 39.5 (area

under the curve 0.79, p<0.001). Subclinical atherosclerosis group also had longer HIV infection duration

(85.4 vs. 67.2 months, p=0.006) albeit it was not associated significantly after adjust other variables.

Conclusions: Conventional risk factors including age, hypertension, dyslipidemia were associated with

subclinical atherosclerosis in PLHIV. Particularly, age 39.5 was a cut-off level.

Keywords: HIV, atherosclerosis , carotid intima-media thickness, risk factors, Republic of Korea





Evaluation of lipid profile in HIV patients on dolutegravir,

abacavir, lamivudine, and elvitegravir, emtricitabine,

tenofovir alafenamide - A single center clinical experience

Sang Woon Bae, Youn Jeong Kim, Sang Il Kim, Yoon Hee Jun

Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea

Background: As an era that HIV infection treated with excellent anti-retroviral therapy (ART) such as

dolutegravir and elvitegravir is a long term maintained disease, HIV specialists have to care for people

living with HIV; who would have healthier and longer elderly life, being concerned about their

dyslipidemia, overweight, and cardio- and cerebrovascular diseases.

Method: A total of 299 patient medical records were reviewed. All of them are on single-pill ART,

including dolutegravir, abacavir, lamivudine (DTG/ABC/3TC), or elvitegravir, emtricitabine, tenofovir

alafenamide (EVG/ FTC/TAF). We used the Cox proportional hazards model to determine associations

between ART treatment regimen and lipid profile changes. Increased total cholesterol (TC) was defined

when the difference of TC levels on baseline and event dates equals to or greater than 20 mg/dl.

Increased low-density lipoprotein cholesterol (LDL) was defined likewise. We defined body-weight gain

as a five percentile gain between the baseline and event dates.

Results: DTG/ABC/3TC group (n=136) and EVG/FTC/TAF (n=123) group did not differ in terms of age

(p=0.26), CD4 T cell count (p=0.26), eGFR (p=0.19), baseline LDL (p=0.81), triglyceride (p=0.25), and

HDL (p=0.12). Treatment duration was significantly longer in DTG/ABC/3TC group compared with

EVG/FTC/TAF group (median 428.5 vs. 321, p=7.182E-08).

In the Cox regression analyses, increased LDL levels were associated with EVG/FTC/TAF (HR=3.17)

and less than 200 mg/dl of baseline TC level (HR=4.35). Also, increased TC was associated with

EVG/FTC/TAF (HR=3.26), less than 200 mg/dl of baseline TC level (HR=3.16), and well-controlled viral

copy (HR=0.47).

Conclusion: EVG/FTC/TAF has increased LDL and total cholesterol levels compared to DTG/ABC/3TC.

Baseline cholesterol is also an essential factor in lipid profile change during ART, while body weight

showed no significance in this study.

Keywords: HIV Integrase Inhibitors, Dyslipidemias, HIV

E-poster session



Rate of and risk factors for loss to follow up in

HIV-infected patients in South Korea: The Korea HIV/AIDS

Cohort study

Hye Seong1,2,4, Yunsu Choi3, Min Jeong Kim4, Joon Young Song5, Shin-Woo Kim6, Sang Il Kim7, Mee-Kyung Kee8, Bo Youl

Choi3, Jun-Yong Choi1,2

1Department of Internal Medicine; 2AIDS Research Institute, Yonsei University College of Medicine, Seoul; 3Department of Preventive Medicine, Hanyang University College of Medicine; 4Institute for Health and Society, Hanyang University, Seoul, Korea; 5Department of Internal Medicine, Korea University College of Medicine, Seoul; 6Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu; 7Department of Internal Medicine, Catholic University College of Medicine, Seoul; 8Division of Viral Disease Research, Korea Centers for Disease Control and Prevention, Cheongju, Korea

Background/Aims: Owing to antiretroviral therapy (ART), the acquired immune deficiency syndrome

(AIDS)-related mortality has significantly decreased. Retaining care is an essential step for HIV care

cascade. This study investigated the incidence of and risk factors for loss to follow-up (LTFU) in Korean

people living with HIV (PLWH).

Methods: Data from the Korea HIV/AIDS cohort study (including prospective interval cohort and

retrospective clinical cohort) were analyzed. LTFU was defined as not visiting clinic more than 1 year.

Risk factors for LTFU were identified using Cox regression hazard model.

Results: The study enrolled 3,172 adult HIV patients (median age, 36 years; male 92.97%). The median

CD4 T cell count at enrollment was 234 cells/mm3 (interquartile range [IQR], 85- 373) and median viral

load at enrollment was 56,100 copies/mL (IQR, 15,000-203,992). The total follow-up duration was

16,487 person-years, and the overall incidence rate of LTFU was 85/1000 person-years.

In the multivariable Cox regression model, subjects on ART were less likely to have LTFU than subjects not

on ART (hazard ratio [HR]= 0.253, 95% confidence interval [CI]: 0.220-0.291, p<0.0001). Among PLWH on

ART, female sex (HR = 0.752, 95 % CI: 0.582-0.971, p=0.0291) and older age (>50: HR = 0.732, 95% CI:

0.602-0.890; 41-50: HR = 0.634, 95% CI:0.530-0.750; 31-40: HR = 0.724, 95% CI: 0.618-0.847; ≤30:

reference, p<0.0001) were associated with lower rate of LTFU. A recent viral load ≥1,000,001 (HR = 1.545,

95 % CI: 1.126-2.121, ≤10,000: reference) was associated with higher rate of LTFU.

Conclusion: Young and male PLWH may have higher rate of LTFU, and increased rate of LTFU may

induce virologic failure.




Keywords: antiretroviral therapy, human immunodeficiency virus, loss to follow up, Korea HIV/AIDS

cohort, risk factor

267

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lude

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inic

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Fig

ure

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A F

low

char

t desc

ribin

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he p

atie

nts

enro

lled i

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Kore

an H

IV/A

IDS

cohort

, 1987-2016.

268

(a)

(b)

Fig

ure

2.

Num

ber

of

loss

to f

ollo

w-up (

LTFU

) pat

ients

and L

TFU

inci

dence

rat

es.

(a)

LTFU

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dence

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by

follo

w-up d

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ure

3.

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ratified b

y risk

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rat

es

by

HIV

dia

gnosi

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ar;

(b)

LTFU

rate

s by

antire

trovi

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269

(a)

(b)

(a)

(b)

Fig

ure

4.

Kap

lan-M

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r cu

rves

for

loss

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ollo

w-up (

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) st

ratified b

y risk

fac

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atie

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with a

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(AR

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(a)

LTFU

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gender;

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LTFU

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by

the y

ear

of

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T i

nitia

tion;

(c)

LTFU

rat

es

by

age a

t A

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nitia

tion;

(d)

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rat

es

by

HIV

viral

load

at

AR

T i

nitia

tion.




N (%) Total In Care Loss to Follow-up p-value

Total 3,172(100.00) 1,766(55.67) 1,406(44.33) <.0001

Sex

Male 2,949(92.97) 1,634(92.53) 1,315(93.53) 0.2727

Female 223(7.03) 132(7.47) 91(6.47)

HIV Transmission Route

Sexual contact 2,003(63.15) 1,171(66.31) 832(59.17) <.0001

: Homosexual 862(43.04) 481(41.08) 381(45.79) <.0001

: Heterosexual 734(36.65) 452(38.60) 282(33.89) 　

: Bisexual 295(14.73) 200(17.08) 95(11.42) 　

: Unknown 112(5.59) 38(3.25) 74(8.89) 　

Injecting drug user 3(0.09) 0(0.00) 3(0.21)

Other 8(0.25) 4(0.23) 4(0.28)

Unknown 1,158(36.51) 591(33.47) 567(40.33)

Year of Diagnosis <.0001

≤2000 263(8.29) 110(6.23) 153(10.88)

2001-2005 740(23.33) 350(19.82) 390(27.74)

2006-2010 1,015(32.00) 542(30.69) 473(33.64)

2011-2016 1,154(36.38) 764(43.26) 390(27.74)

Age at Diagnosis 0.0022

≤30 1,047(33.01) 544(30.80) 503(35.78)

31-40 926(29.19) 509(28.82) 417(29.66)

41-50 707(22.29) 410(23.22) 297(21.12)

>50 492(15.51) 303(17.16) 189(13.44)

Median(Q1-Q3) 36(28-45) 37(29-46) 35(27-44) <.0001

CD4 counts(cells/uL) at Diagnosis <.0001

<100 563(17.75) 340(19.25) 223(15.86)

100-199 310(9.77) 202(11.44) 108(7.68)

200-349 588(18.54) 339(19.20) 249(17.71)

≥350 582(18.35) 340(19.25) 242(17.21)

Unknown 1,129(35.59) 545(30.86) 584(41.54)

Median(Q1-Q3) 234(85-373) 228(81.5-367) 241.5(88-385) 0.3727

Viral load(copies/mL) at Diagnosis

≤10,000 362(11.41) 198(11.21) 164(11.66) <.0001

10,001-100,000 774(24.4) 474(26.84) 300(21.34)

100,001-1,000,000 520(16.39) 325(18.40) 195(13.87)

≥1,000,001 151(4.76) 96(5.44) 55(3.91)

Unknown 1,365(43.03) 673(38.11) 692(49.22)

Median(Q1-Q3) 56100 59500 49154.5 0.0068

Table 1. Baseline characteristics of 3,172 enrolled patients.

E-poster session


N (%) Total In Care Loss to Follow-up p-value

(15000-203992) (17062-229462) (11700-180000)

ART

No 439(13.84) 103(5.83) 336(23.90) <.0001

Yes 2,733(86.16) 1,663(94.17) 1,070(76.10)

: Year of ART initiation 　　　 <.0001

　 ≤2000 128(4.68) 45(2.71) 83(7.76)

　 2001-2005 493(18.04) 239(14.31) 255(23.83) 　

　 2006-2010 921(33.7) 542(32.59) 379(35.42) 　

　 2011-2016 1,191(43.58) 838(50.39) 353(32.99) 　

: Age at ART initation 　　　 0.021

　 ≤30 712(26.05) 426(25.62) 286(26.73)

　 31-40 862(31.54) 497(29.89) 365(34.11) 　

　 41-50 679(24.84) 424(25.50) 255(23.83) 　

　 >50 480(17.56) 316(19.00) 164(15.33) 　

　 Median(Q1-Q3) 38(30-47) 39(30-48) 37(30-46) 0.0358

: CD4 counts(cells/uL) at ART initiation 　　　 <.0001

　 <100 702(25.69) 434(26.10) 268(25.05)

　 100-199 468(17.12) 280(16.84) 188(17.57) 　

　 200-349 817(29.89) 487(29.28) 330(30.84) 　

　 ≥350 509(18.62) 352(21.17) 157(14.67) 　

　 Unknown 237(8.67) 110(6.61) 127(11.87) 　

　 Median(Q1-Q3) 212(82.5-324) 219(83-338) 207(82-304) 0.0140

: Viral load(copies/mL) at ART initiation 　　　 <.0001

　 ≤10,000 494(18.08) 314(18.88) 180(16.82)

　 10,001-100,000 983(35.97) 621(37.34) 362(33.83) 　

　 100,001-1,000,000 675(24.70) 428(25.74) 247(23.08) 　

　 ≥1,000,001 133(4.87) 81(4.87) 52(4.86) 　

　 Unknown 448(16.39) 219(13.17) 229(21.40) 　

　 Median(Q1-Q3)55600

(13400-185000)

53500

(12481.5-190000)

57000

(14100-180000)0.9031

: First ART regimen 　　　 <.0001　

　 NRTI 70(2.56) 32(1.92) 38(3.55)

　 NRTI + INI 499(18.26) 389(23.39) 110(10.28) 　

　 NRTI + PI 1,404(51.37) 797(47.93) 607(56.73) 　

　 OTHER 760(27.81) 445(26.76) 315(29.44) 　

NRTI, nucleoside/nucleotide reverse transcriptase inhibitor; INI, integrase inhibitor; PI, protease inhibitor.




Follow-up year Total N LTFU N Person-years Incidence per 1,000 pys

Total 3,172 1,407 16487.080 85.340

≤1 426 307 182.925 1678.280

≤2 375 209 560.271 373.033

≤3 562 182 1360.505 133.774

≤4 351 137 1226.292 111.719

≤5 255 102 1137.423 89.676

≤6 180 79 992.797 79.573

≤7 154 67 1002.185 66.854

≤8 118 52 890.857 58.371

≤9 109 41 933.023 43.943

≤10 132 50 1256.741 39.785

≤11 120 37 1262.255 29.313

≤12 86 28 990.497 28.269

≤13 77 24 960.591 24.985

≤14 58 23 782.455 29.395

≤15 38 17 549.286 30.949

≤16 31 17 477.658 35.590

≤17 24 8 396.147 20.195

≤18 24 12 417.882 28.716

≤19 9 2 165.713 12.069

≤20 6 1 116.006 8.620

≤21 14 5 286.128 17.475

≤22 6 2 129.837 15.404

≤23 6 2 136.928 14.606

≤24 5 1 117.696 8.496

≤25 3 0 74.181 0.000

≤26 2 2 50.701 39.447

≤27 0 0 0.000 0.000

≤28 0 0 0.000 0.000

≤29 1 0 28.783 0.000

N, numbers; LTFU, loss to follow up.* Follow-up duration: from the date of positive confirmation to the last observation or death date.

Table 2-1. Loss to follow-up incidence rates by follow-up duration* (years)

E-poster session


Year Total N LTFU N Person-years Incidence per 1,000 pys

Total 3,172 1,407 16487.080 85.340

1987 1 0 0.734 0.000

1988 2 0 1.642 0.000

1989 7 0 5.622 0.000

1990 12 0 9.438 0.000

1991 17 0 14.364 0.000

1992 30 0 24.068 0.000

1993 42 2 37.099 53.910

1994 58 1 49.904 20.038

1995 78 0 69.479 0.000

1996 99 0 91.770 0.000

1997 125 1 112.110 8.920

1998 165 8 140.904 56.776

1999 200 6 172.334 34.816

2000 245 10 217.115 46.059

2001 321 17 268.594 63.293

2002 425 18 362.255 49.689

2003 542 27 467.101 57.803

2004 692 24 592.902 40.479

2005 889 35 760.408 46.028

2006 1,087 32 968.647 33.036

2007 1,252 61 1,129.838 53.990

2008 1,393 90 1,239.604 72.604

2009 1,485 133 1,267.951 104.894

2010 1,463 96 1,237.263 77.591

2011 1,466 81 1,287.238 62.925

2012 1,556 97 1,333.770 72.726

2013 1,592 92 1,369.666 67.170

2014 1,647 70 1,443.416 48.496

2015 1,678 505 1,474.751 342.431

2016 1,160 0 302.462 0.000

N, numbers; LTFU, loss to follow up.

Table 2-2. Loss to follow-up incidence rates by year

274

n=3,

139

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es p

er

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(95

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ultiv

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renc

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refe

renc

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284

4

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ale

91/

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463.

47 (51.

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0.7

19

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oute

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6071

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45

0.7

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09

0.7

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Sex

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unk

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565

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23-

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57

0.6

83-1.0

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5398.8

82 (91.

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1.1

76

1.0

36-

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51.0

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0.8

90-1.1

58

Yea

r of

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gnos

is

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153/

3,4

2444.

69 (38.

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refe

renc

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000

1

refe

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0001

2001-

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390/

5,8

6066.

56 (60.

27-73.

50)

2.6

12

2.0

63-

3.30

62.3

68

1.8

6-3.0

13

2006-

2010

473/

4,6

71101.

27 (92.

54-110.

82)

4.7

48

3.7

04-

6.08

63.8

69

2.9

83-5.0

18

2011-

2016

390/

2,5

45153

.23 (13

8.76-

169.

22)

7.5

46

5.8

03-

9.81

35.9

81

4.5

34-7.8

88

Age

at

HIV

Dia

gnos

is

≤30

503/

5,4

4592

.38 (84

.65-

100

.82)

refe

renc

e0.

2054

refe

renc

e0.

122

7

31-40

417/

5,2

5379.

39 (72.

12-87.

38)

0.8

76

0.7

69-

0.99

80.8

86

0.7

77-1.0

11

41-50

297/

3,6

4181.

57 (72.

80-91.

40)

0.8

99

0.7

79-

1.03

90.8

47

0.7

32-0.9

82

>50

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107

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98-74.

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56

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0.29

0　

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. Fac

tors

ass

oci

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oss

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ollo

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3,79

860.

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97-68.

63)

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0.90

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0.7

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1.08

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ct -

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66

55.

65 (44.

45-69.

68)

0.7

72

0.601

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93

0.79

1

0.6

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ther

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n**

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5,86

577.

92 (71.

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40)

1.0

65

0.922

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0.9

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1.23

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of A

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tion

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35

54.

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61-67.

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fere

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2001

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4,29

859.

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48-67.

09)

1.2

80

0.992

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1.38

3

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44-

1.83

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-2010

379/

5,40

770.

09 (63.

38-77.

52)

1.5

94

1.244

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43

1.63

6

1.2

32-

2.17

42011

-2016

353/

4,03

587.

49 (78.

82-97.

11)

2.0

76

1.608

-2.6

80

2.20

4

1.6

28-

2.98

5A

ge a

t A

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initat

ion

≤30

286/

3,16

390

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101

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renc

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000

1re

fere

nce

<.0001

31-

40

365/

5,41

167.

46 (60.

88-74.

74)

0.7

32

0.626

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55

0.72

4

0.6

18-

0.84

741-

50

255/

4,28

359.

55 (52.

67-67.

32)

0.6

46

0.545

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65

0.63

1

0.5

30-

0.75

1>5

0164/

2,41

767.

84 (58.

21-79.

06)

0.7

54

0.622

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0.73

2

0.6

02-

0.89

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coun

ts(c

ells

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at

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itia

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4,05

666.

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62-74.

48)

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100-

199

188/

2,69

269.

85 (60.

55-80.

58)

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48

0.870

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1.04

9

0.8

66-

1.27

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349

330/

4,38

075.

35 (67.

64-83.

93)

1.1

42

0.972

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42

1.16

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0.9

80-

1.38

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350

157/

2,32

467.

56 (57.

78-79.

00)

1.0

20

0.837

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0.8

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1.26

7U

nkno

wn

127/

1,82

369.

67 (58.

54-82.

90)

1.0

25

0.830

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1

0.9

06-

1.41

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iral

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(cop

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19-72.

58)

refe

renc

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0

10,0

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4,76

775.

95 (68.

51-84.

19)

1.2

24

1.023

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64

1.17

2

0.9

76-

1.40

7100,

001-

1,0

00,0

00

247/

3,35

773.

59 (64.

96-83.

36)

1.1

85

0.977

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36

1.21

3

0.9

89-

1.48

7≥

1,0

00,0

01

52/5

48

94.9

3 (72

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124

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1.5

41

1.1

31,

2.0

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545

1.12

6, 2

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now

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3,73

361.

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89-69.

82)

0.9

23

0.7

58,

1.1

251.

048

0.84

2, 1

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t A

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men

NR

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59.

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43-82.

03)

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renc

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1284

refe

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452

8

NR

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1,39

378.

96 (65.

50-95.

18)

1.5

40

1.0

55,

2.2

460.

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0.57

7, 1

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PI

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8,78

969.

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78-74.

78)

1.2

82

0.9

19,

1.7

881.

063

0.73

7, 1

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THER

315/

4,45

570.

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31-78.

96)

1.3

26

0.9

42,

1.8

68　

1.00

9

0.68

9, 1

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, ha

zard

rat

io; C

I, c

onfide

ntia

l int

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l; A

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ant

iret

rovi

ral t

hera

py.

Tab

le 4

. Fac

tors

ass

oci

ated w

ith l

oss

to f

ollo

w-up i

n A

RT p

atie

nts

(P

rosp

ect

ive+

Retr

osp

ect

ive)





Incidence and Risk factor of Human Immunodeficiency

Virus-Associated Immune Reconstitution Inflammatory

Syndrome in South Korea; for Integrase strand transfer

Inhibitors versus other antiretrovirals

Jin Kim1, Hyun-Ju Nam1, Yu-Jin Jung3, Hye-Jung Lee3, Sook-In Jung1, Yeon-Sook Kim2, Hyun-Ha Chang3, Shin-Woo Kim3,

Kyung-Hwa Park1

1Department of Infectious Diseases, Chonnam National University Hospital, Gwangju, Republic of Korea, 2Department of Internal Medicine, Chungnam National Hospital, Deajeon, Republic of Korea, 3Department of Internal Medicine, Kyungpook National Hospital, Daegu, Republic of Korea

Background: Immune reconstitution inflammatory syndrome (IRIS) is a major concern when starting

antiretroviral therapy (ART) in patients with advanced HIV infection. We determined the incidence and

risk factors of IRIS in HIV-infected Koreans initiating ART, and whether integrase strand transfer

inhibitor (INSTI) increases the risk of IRIS.

Methods: This retrospective analysis included adults living with HIV, seen at four university-affiliated

hospitals in South Korea, who were naïve to ART and had a CD4+ T-cell count < 200 cells/mm3 between

January 2004 and May 2019. IRIS was determined through a medical record review within 6 months of

ART initiation.

Results: The study included 501 patients; 192 were assigned to the INSTI group, who started ART after

INSTI as the initial treatment. There were opportunistic infections (OI) in 253 (50.5%) cases before ART

initiation. The three most common OIs were Pneumocystis jirovecii pneumonia (PCP), candidiasis, and

tuberculosis (TB). We identified 47 cases of IRIS; TB-IRIS was the most type. The incidence of IRIS

within 6 months of ART initiation was 9.4%, and the incidence of IRIS was the same between the

non-INSTI and INSTI groups. The risk factors for IRIS were pre-ART CD4+ T-cell count (< 30 cells/mm3),

higher pre-ART viral load (≥ 75,000 copies/mL), and TB-OI.

Conclusions: The incidence of IRIS was 9.4% in Korean HIV patients. The INSTI regimen was not related

to IRIS occurrence.

Keywords: Human immunodeficiency virus, immune reconstitution inflammatory syndrome, integrase

strand transfer inhibitor, antiretroviral therapy, tuberculosis

E-poster session



Lenacapavir Resistance Analysis in a Phase 1b Clinical

Proof-Of-Concept Study

Nicolas Margot , Jeong-a Lee , Renee Ram , PC Parvangada , Ross Martin , Rob Hyland , Martin Rhee , Christian Callebaut

Gilead Sciences, Inc., Foster City, California, USA

Background: Lenacapavir (LEN, GS-6207) is a first-in-class subcutaneous (SC) long acting inhibitor of

HIV-1 capsid function, which can be administered every 6 months. In vitro resistance selections with

LEN have identified 7 mutations in HIV-1 capsid protein (CA) associated with reduced susceptibility to

LEN. We conducted a phase 1b proof-of-concept study in which people living with HIV (PLWH)

received a single SC injection of LEN 20, 50, 150, 450, or 750 mg. LEN demonstrated potent antiviral

activity with up to 2.3 log10 decline in HIV-1 RNA after 9 days of monotherapy.

Methods: Study 4072 is a double-blind, placebo-controlled, dose-ranging, randomized (3:1; n=8/group)

study in PLWH who were capsid inhibitor-naive. Resistance analyses were performed for all

participants prior to study entry and at the end of monotherapy using genotypic and phenotypic Gag-Pro

assays (Monogram Biosciences) and next-generation sequencing (NGS; Seq-IT). Samples were

evaluated for the emergence of CA mutations and/or change in phenotypic susceptibility to LEN.

Results: Thirty-nine PLWH enrolled in the study, 29 receiving LEN and 10 receiving placebo. All PLWH

responded to LEN with no rebound. In the pre-treatment analysis, none had HIV-1 harboring resistance

mutations to LEN, with all having wild-type (WT) phenotypic susceptibility to LEN. Post-monotherapy

analyses revealed the emergence of CA mutation Q67H at Day 10 in 2 participants. One participant (20

mg group) had a Q67Q/H mixture detected both by population and NGS analysis, and another

participant (50 mg group) had a Q67H mutation, detected only by the NGS analysis. No other

substitutions were observed in the CA protein.

Conclusions: Overall, emergence of resistance to LEN was rare and only occurred well below exposures

expected to be achieved in Ph2/3 studies, with the emergence of a single mutation Q67H. These

results support further evaluation of LEN as a long-acting antiretroviral agent in PLWH.

Keywords: HIV, long-acting ART





코로나19 지역사회 발생이 감염인 상담에 미치는 영향

서아영, 이정휘, 이수연, 최재필, 오동현, 안미영

서울특별시 서울의료원 감염내과

배경: 코로나-19 는 2019 년 12 월 중국 우한에서 처음 발생한 이후 중국 전역과 전 세계로 확산된, 새로운 유형의 코로

나바이러스(SARS-CoV-2)에 의한 호흡기 감염질환이다. 이에 정기적으로 의료기관을 방문해야 하는 감염인들의 의료

기관 방문이 어렵고, 기존 진행되던 상담사업의 내담자의 수와 상담 횟수를 감소시켜 감염인의 건강 관리지표가 악화될

가능성이 높다.

연구 방법: 의료기관감염인상담사업의 총괄사업기관인 서울특별시 서울의료원이 매월 말 기준으로 각 사업수행 의료기

관에서 취합하여 질병관리청에 제출하는 월보고 실적과 코로나-19 발생현황을 비교하여 코로나 19 발생현황이 상담사

업 수행에 미치는 영향을 파악하고자 하였다.

2019 년과 2020 년 1 월~9 월 상담 실적을 코로나 19 발생 시기에 따라 서울·경기·인천, 대구·경북, 코로나-19 전담

병원인 서울의료원으로 나누어 비교하였다.

연구 결과

Figure 1. 2019년과 2020년도 대면 건수 비율 비교

E-poster session


- 서울·경기·인천 지역의 경우 5 월 (이태원 클럽 사례), 8 월 (사랑제일교회 및 광화문 집회사례)에는 서울·경기·인천

지역에 위치한 의료기관의 대면상담 건수가 1 월 기준 11.9%, 20.9%로 낮아 졌다.

- 대구·경북 지역에 위치한 의료기관의 경우 1 월 기준 3 월(신천지 대구 교회 사례) 대면 상담건수가 89 건(64.3%)으

로 감소, 전화ㆍ온라인 상담은 270 건(58%)으로 증가하였다.

- 코로나 전담병원인 서울의료원의 경우 1 월 기준 5 월(이태원 클럽 사례), 8 월(사랑제일교회 및 광화문 집회사례)에는

대면 건수가 40 건(58.4%), 34 건(64.6%)으로 감소하였다.

- 의료기관감염인상담사업 40copies/ml 기준 바이러스 억제비율은 2019 년 최종보고서 93.8% 과 2020 년 중간보

고서 93.2%로 차이가 없었다.

- 2019 년도와 2020 년도의 총 상담건수의 소계 차이는 크게 없지만 상담의 형태가 바뀐 것을 알 수 있다. 2019 년은

대면상담의 건수가 높은 반면 2020 년은 코로나-19 의 영향으로 2019 년 대비 대면보다는 전화, 온라인상담의 건수

가 높다.

결론: 코로나-19 로 인해 상담유형이 대면이 줄고 비대면 방법(전화, 온라인)이 증가하여 상담건수는 유지되었다. 감염

인들의 의료기관 방문이 어려워졌음에도 불구하고 다양한 상당방법의 관리로 바이러스억제비율 또한 유지할 수 있었던

것으로 판단된다. 지속되는 코로나-19 상황에서 HIV/AIDS 감염인의 병원이용, 효과적인 상담 방법에 대한 다양한 연

구가 필요하다.





Starting or switching to bictegravir/emtricitabine/tenofovir

alafenamide (B/F/TAF) in clinical practice: Pooled

12-month (12M) results from the global BICSTaR study

Christoph Spinner1, Jeong-a Lee12, Albrecht Stoehr2, Alex Wong3, Joss de Wet4, Jérémy Zeggagh5, Laurent Hocqueloux6, Berend van Welzen7, Marion Heinzkill8, Sabrinel Sahali9, Almudena Torres Cornejo10, Heribert Ramroth11, Richard Haubrich12,

David Thorpe11, Connie Kim13

1Technical University of Munich, School of Medicine, University Hospital Rechts der Isar, Munich, Germany; 2IFI Studien und Projekte GmbH, Hamburg, Germany; 3Department of Medicine, University of Saskatchewan, Regina, Canada; 4Spectrum Health, Vancouver, Canada; 5Service des Maladies Infectieuses, Hôpital Saint Louis, APHP, Paris, France; 6Service des Maladies Infectieuses et Tropicales, CHR d'Orléans, Orléans, France; 7University Medical Centre, Utrecht, Netherlands; 8Gilead Sciences GmbH, Munich, Germany; 9Gilead Sciences, Boulogne-Billancourt, France; 10Gilead Sciences, Amsterdam, Netherlands; 11Gilead Sciences Ltd, London, UK; 12Gilead Sciences USA, Foster City, USA; 13Gilead Sciences Canada Inc, Ontario, Canada, 12Gilead Korea, Seoul, Korea

Background: The ongoing observational BICSTaR study aims to demonstrate effectiveness, safety and tolerability of B/F/TAF in routine clinical practice in at least 1400 antiretroviral treatment (ART)?na?ve (TN) and ART?experienced (TE) people living with HIV (PLHIV).

Materials and Methods: This 12M analysis of PLHIV receiving B/F/TAF in Europe and Canada assessed HIV?1 RNA (missing data=excluded analysis), drug?related (DR) adverse events (AEs), persistence and weight/body-mass index (BMI) change.

Results: At the time of data cut-off (Mar 2020), 513 participants (n=84 TN/n=429 TE) completed a 12M visit. Prevalence of comorbidities at baseline was 76%; the most common were neuropsychiatric (28%), hyperlipidemia (18%) and hypertension (18%). 71%/18%/13% of TE participants switched from INSTI/NNRTI/PI-based regimens, respectively (26% TDF); 8% had a history of prior virologic failure. Baseline primary resistance prevalence by historical genotype was 9% (n=43/513)At M12, 100% of TN (n=74/74) and 96% (n=357/373) TE participants had viral load (VL) <50 copies/ml. Comparable and high effectiveness was observed in both male and female participants, including older individuals (Table). No major resistance substitutions to the components of B/F/TAF emerged.DRAEs occurred in 14% (n=12/84) of TN and 15% (n=64/429) of TE participants, with the most common being gastrointestinal (5%) and neuropsychiatric (4%); discontinuations due to DRAE were low (TN 3.6% and 7.2% TE). Serious DRAEs were rare (0.4%; all in TE participants [n=2 depression]).At 12M, median (Q1, Q3) weight change was +2.5 kg (0.5, 6.3) for TN (n=48) and +0.9 kg (?1.0, 3.0) for TE (n=269). Weight increase >10% was observed in 19% (n=9/48) and 5% (n=15/269) of TN and TE participants, respectively.

Conclusions: The use of B/F/TAF in this real-world clinical cohort was associated with a high level of effectiveness and safety through 12M, inclusive of male, female and older PLHIV.

Keywords: B/F/TAF, real world evidence

E-poster session



Durable Efficacy of Dolutegravir (DTG) Plus Lamivudine

(3TC) in Antiretroviral Treatment-Naïve Adults With HIV-1 Infection -3-Year Results From the GEMINI Studies

P Cahn1, J Sierra Madero2, J Arribas3, A Antinori4, R Ortiz5, A Clarke6, C-C Hung7, J Rockstroh8, P-M Girard9, J Sievers10, C

Man11, R Urbaityte12, M Underwood11, K Pappa11, B Wynne11, M Gartland11, M Aboud10, J van Wyk10, K Smith11, S Kwon13

1Fundación Huésped, Buenos Aires, Argentina; 2Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico; 3Hospital La Paz, Madrid, Spain; 4Istituto Nazionale per le Malattie Infettive Lazzaro Spallanzani, Rome, Italy; 5Bliss Healthcare Services, Orlando, FL, USA; 6Royal Sussex County Hospital and Brighton & Sussex Medical School, Brighton, UK; 7National Taiwan University Hospital, Taipei, Taiwan; 8Rheinische Friedrich-Wilhelms Universität, Bonn, Germany; 9Hôpital Saint Antoine, Paris, France; 10ViiV Healthcare, Brentford, UK; 11ViiV Healthcare, Research Triangle Park, NC, USA; 12GlaxoSmithKline, Stockley Park, UK; 13GlaxoSmithKline, Seoul, South Korea

Background: Two-drug regimens (2DR) have the potential to reduce cumulative drug exposure during

life-long antiretroviral therapy in HIV-1 infected patients. In GEMINI-1 and GEMINI-2 (ClinicalTrials.gov:

NCT02831673/NCT02831764), the efficacy of the 2DR of DTG+3TC was non-inferior to DTG+

tenofovir/emtricitabine (TDF/FTC) at weeks 48 and 96 in treatment-naïve adults.

Method: GEMINI-1&2 are identical double-blind, multicentre Phase III studies. Participants with HIV-1

RNA ≤500,000c/mL at screening were randomised 1:1 (stratified by plasma HIV-1 RNA and CD4+ cell

count) to once-daily treatment with DTG+3TC or DTG+TDF/FTC. The primary endpoint was the

proportion of participants with plasma HIV-1 RNA < 50c/mL at week 48 (Snapshot algorithm). We

present efficacy and safety data from prespecified 144-week secondary analyses. Estimates and

confidence intervals were based on a stratified analysis using Cochran-Mantel-Haenszel weights.

Results: 714 and 719 adults were randomised and treated in GEMINI-1&2, respectively. At baseline,

20% had HIV-1 RNA >100,000c/mL, 8% had CD4+ <200cells/mm3. At week 144, DTG+3TC was

non-inferior to DTG+TDF/FTC in both GEMINI-1&2 and in the pooled analysis (using a 10%

non-inferiority margin) [Table]. Response rates in participants with baseline HIV-1 RNA >100,000c/mL

were high and similar between arms. Consistent with week 48 and 96 outcomes, response remained

lower in DTG+3TC participants with CD4+ <200cells/mm3. Across both studies, 12 participants on

DTG+3TC (1 since week 96) and 9 on DTG+TDF/FTC (2 since week 96) met protocol-defined confirmed

virologic withdrawal (CVW) criteria through week 144; none had treatment-emergent integrase strand

transfer inhibitor or NRTI resistance mutations. One non-CVW DTG+3TC participant with reported

non-adherence developed M184V (week 132; HIV-1 RNA 61,927c/mL) and added R263R/K at week

144 (135c/mL), conferring a 1.8-fold change in DTG susceptibility. Overall rates of AEs were similar,




with low rates of withdrawals due to AEs in both arms. DTG+3TC had a significantly lower rate of

drug-related AEs than DTG+TDF/FTC (20% vs 27%; relative risk ratio,0.76;95%CI:0.63-0.92).

Post-baseline changes in markers of bone and renal function favoured DTG+3TC through week 144.

Conclusion: DTG+3TC remains non-inferior to DTG+TDF/FTC in treatment-naïve adults at week 144.

Both regimens were well tolerated. The results demonstrate durable efficacy and potency of DTG+3TC,

further supporting it as a first-line option for HIV treatment.

Keywords: HIV Dolutegravir

GEMINI-1 GEMINI-2 Pooled

Snapshot responders DTG+3TC 281/356 (79%) 303/360 (84%) 584/716 (82%)

DTG+TDF/FTC 296/358 (83%) 303/359 (84%) 599/717 (84%)

Adjusted Difference (95% CI) -3.6 (-9.4, 2.1) 0.0 (-5.3, 5.3) -1.8 (-5.8, 2.1)

[Proportion of participants with plasma HIV-1 RNA <50 c/mL at week 144: Snapshot analysis – ITT-E population]

Data from this abstract were previously presented in full at HIV Drug Therapy Glasgow 2020; October

5-8, 2020; Virtual.

E-poster session



Safety and Efficacy of Cabotegravir + Rilpivirine

Long-Acting With and Without Oral Lead-In: FLAIR Week

124 Results

Ronald D’Amico1, Chloe Orkin2, Enrique Bernal Morell3, Darrell H.S. Tan4, Harold Katner5, Yashna Singh6, Hans-Jürgen Stellbrink7, Elena Belonosova8, Rebecca DeMoor9, Sandy Griffith1, Shanker Thiagarajah9, Rodica Van Solingen-Ristea10, Herta

Crauwels10, Susan L. Ford11, Parul Patel1, Amy Cutrell1, Kimberly Y. Smith1, Kati Vandermeulen10, David A. Margolis1, Marty St.

Clair1, William R. Spreen1, Sungshin Kwon12

1ViiV Healthcare, Research Triangle Park, NC, USA; 2Queen Mary University, London, UK; 3Hospital General Universitario Reina Sofía, Murcia, Spain; 4Division of Infectious Diseases, St. Michael's Hospital, Toronto, Canada; 5Mercer University Medical School, Macon, GA, USA; 6Desmond Tutu HIV Foundation, Cape Town, South Africa; 7ICH Study Center, Hamburg, Germany; 8Orel Regional Center for AIDS, Orel, Russia; 9GlaxoSmithKline, London, UK; 10Janssen Research and Development, Beerse, Belgium; 11GlaxoSmithKline, NC, USA; 12GlaxoSmithKline, Seoul, Korea

Background: FLAIR (NCT02938520), a phase III, randomized, open-label study, established

noninferiority of switching virologically suppressed participants (pts) from daily oral DTG/ABC/3TC

(CAR) to monthly CAB+RPV LA following CAB+RPV oral lead-in (OLI) over 2 y. We report results from

the Extension Phase on efficacy, safety, and tolerability of switching CAR arm pts to LA therapy ± OLI.

Method: ART-naive pts achieving virologic suppression (HIV-1 RNA <50c/mL) with CAR during the

20-wk Induction Phase were randomized (1:1) to continue CAR or switch to LA (n=283 each). Pts

randomized to LA therapy received an OLI of CAB+RPV once daily for ≥4 wk before receiving monthly

injectable CAB+RPV LA. At W100, CAR pts could switch to LA therapy (Extension Switch population),

either directly (Direct to Inject [DTI] arm) or with a 4-wk OLI (OLI arm), or withdraw. Endpoints

assessed at W124 for Extension Switch population included plasma HIV-1 RNA ≥50c/mL and

<50c/mL, CVF (2 consecutive HIV-1 RNA ≥200c/mL), safety, and tolerability.

Results: In total, 111 and 121 CAR arm pts transitioned to CAB+RPV LA, entering the DTI or OLI arms,

respectively. At W124, 1 pt (<1%) in each arm had HIV-1 RNA ≥50c/mL (Table; Figure). Further, 99%

and 93% of pts in the DTI and OLI arms maintained virologic suppression (HIV-1 RNA <50c/mL),

respectively. 1 pt in the DTI arm developed CVF at W112. AEs leading to withdrawal were infrequent.

There was 1 grade 4 drug-related AE in the DTI arm (mixed cellularity Hodgkin lymphoma). The number

of pts experiencing serious AEs was comparable between arms. Overall, CAB+RPV LA was well

tolerated; injection-site reactions were the most common AE, with most classified as mild/moderate in

severity.




Conclusion: Switching directly to LA therapy without OLI demonstrated similar safety and tolerability to

treatment including OLI. Further, similar efficacy was observed across arms at W124. This suggests

that CAB+RPV LA ± OLI is well-tolerated, effective maintenance therapy.

Keywords: Carbotegravir; injectable; ViiV; long-acting, FLAIR

E-poster session


Outcome, n (%)Extension Switch PopulationTable. Key Outcomes at Week 124 Data

Analysis

DTI armn=111

OLI armn=121

HIV-1 RNA <50c/mL at W124* 110 (99.1) 113 (93.4)

HIV-1 RNA ≥50c/mL at W124* 1 (0.9) 1 (0.8)

Data in window not <50c/mL 0 1 (0.8)†

Discontinued due to lack of efficacy 1 (0.9) 0

Discontinued due to other reasons while not suppressed 0 0

No virologic data in W124 window 0 7 (5.8)

Discontinued study due to AE or death 0 2 (1.7)‡

Discontinued study for other reasons 0 5 (4.1)§

Number of injections 2314 2128

Number of ISR events 576 338

Grade 1 events – mild 478 271

Grade 2 events – moderate 97 62

Grade 3 events – severe 1 5

ISR duration ≤7 days 516 290

Median ISR duration, days 3 3

Withdrawals due to ISRs 0 1 (0.8)

Incidence of skin and subcutaneous tissue disorders (dermatologic AEs) 19 (17.1)║ 10 (8.3)

Maximum Grade 3 or 4 AEs 5 (4.5) 9 (7.4)

Maximum Grade 3 or 4 AEs excluding ISRs 4 (3.6) 5 (4.1)

Maximum drug-related Grade 3 or 4 AEs excluding ISRs 1 (0.9) 0

Maximum Grade 3 or 4 emergent chemistry toxicities 13 (11.7) 5 (4.1)

Serious AEs 4 (3.6) 5 (4.1)

Mean change (range) from Extension Baseline¶ in ALT, IU/L –1.1 (–157, 80) 1.1 (–37, 45)

Mean change (range) from Extension Baseline¶ in AST, IU/L –0.3 (–257, 308) –0.7 (–124, 84)

Mean change (range) from Extension Baseline¶ in bilirubin, μmol/L 1.5 (–14, 24) 1.0 (–8, 14)

Liver monitoring/stopping events 0 0

AE, adverse event; ALT, alanine aminotransferase; AST, aspartate aminotransferase; DTI, Direct to Inject; ISR, injection site reaction;

OLI, oral lead-in; W, Week. *Per FDA Snapshot algorithm. †Participant had HIV-1 RNA of 57c/mL. ‡Two discontinuations after OLI: 1

injection site pain, 1 increased weight. §Two discontinuations during OLI: 1 subject relocation, 1 pregnancy. Three discontinuations after

OLI: 1 burden of procedures and intolerability of injections, 1 burden of travel, 1 use of prohibited medicine. ║Includes 1 cyst and 2

herpes zoster, which were not coded to “skin and subcutaneous tissue disorders”. ¶W100.


5-8, 2020; Virtual.





HIV 감염자에서 발생한 인간유두종바이러스 관련 항문암 4 례

백예지1, 조윤숙 1, 현종훈 1, 김무현 1, 손유진 1, 김정호 1, 안진영 1, 정수진 1, 염준섭 1, 김현기 2, 최준용 1

1 연세대학교 의과대학 내과학 교실, 2 연세대학교 의과대학 병리학 교실

배경: 인간면역결핍바이러스(HIV) 감염 환자들은 항문암의 발생이 일반 인구보다 15~60 배 높은 것으로 알려져 있다.

일반적으로 항문암의 84%는 인간유두종바이러스(HPV)의 아형 중 고위험군에 의한 것으로, 변형대의 점막 이형성세포

를 유발하여 암으로 진행하는 것으로 알려져 있다. 본 연구에서는 HIV 로 항레트로바이러스 치료 중 항문암을 진단받은

4 명의 환자를 기술하고 HPV 와의 관련성을 확인해보고자 하였다.

증례: 증례 1. 34 세부터 HIV 치료하였고, 과거에 치루절제술 하였던 분이다. 50 세에 항문의 불편감으로 내원하여 첨부

콘딜로마 확인되었는데 고등급상피내병변으로 항문연 절제술 시행하였다. 5 년 후 치루 확인 위하여 시행한 대장내시경

에서 첨부콘딜로마 보였고, 편평상피세포암 진단되어 절제술 후 현재 항암방사선치료 예정이다.

증례 2. 28 세에 HIV 진단되어 33 세에 설사와 가스차는 증상으로 시행한 대장 내시경에서 첨부콘딜로마 확인되었다.

항문연 절제술 후 조직검사 상 고등급상피내병변으로 항문상피내종양에 합당하였으며, p16 양성이었다. 이후 첨부콘딜

로마 확인되었으나 저절로 관해되었고 추적 관찰 중에 있다.

증례 3. 43 세부터 HIV 치료 중 51 세에 항문의 미만성대 B 세포림프종 진단되어 항암치료 받고 추적관찰 중이던 분이

다. 5 년 후 항문 통증 및 혈변으로 내시경 시행하여 항문의 편평상피세포의 고분화이형성 및 침범 소견으로 항암방사선

치료를 시작하였으나, 이후 만져지는 종괴에서 편평상피세포암 진단되어 2013 년 수술 후 항암방사선 치료하였다. 현재

는 편도의 편평상피세포암으로 항암방사선 치료 후 추적관찰 중이다.

증례 4. 29 세에 HIV 진단 후 55 세에 점점 커지는 항문연의 종괴로 조직검사 시행하여 편평상피세포암을 확인, 항문암

3 기로 진단되어 술전 항암방사선치료 후 진행 소견으로 수술을 시행하고 보조항암화학요법 및 방사선 치료를 시행하였

고 현재는 호스피스 치료 중에 있다.

결과: 4 증례 모두 항레트로바이러스 치료 중 증상이 있어 대장 내시경을 시행하여 항문암 혹은 항문상피내종양이 확인

된 공통점이 있으나, 증례 1, 2 에서만 p16 IHC 양성, 고위험군 HPV 와 관련이 있는 것으로 나타났다. 증례 3, 4 에서

는 저위험군 HPV 이 발견되었으나 p16 IHC 는 음성이었다.

결론: 항문암은 느리게 진행하는 암이지만 증상 발생 후 진단하면 진행성으로 예후가 불량할 수 있으므로, 고위험군인

HIV 환자들에게서 항문 내시경, 항문 부위 세포진 및 HPV DNA 검사 등의 조기 검사 및 정기적 추적관찰이 중요할 것으

로 생각되며 이에 대한 추가 연구가 필요할 것이다. 또한, 많은 종류의 HPV 의 감염을 예방할 수 있는 HPV 예방접종을

실시하는 것이 도움이 될 것이다.

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E-poster session



Pooled Analysis of 4 International Trials of Bictegravir/

Emtricitabine/Tenofovir Alafenamide (B/F/TAF) in Adults

Aged ≥ 65 or Older Demonstrating Safety and Efficacy:

Week 48 Results

Ramgopal M1, Jeong-a Lee2, Maggiolo F3, Ward D4, Lebouche B5, Rizzardini G6, Molina JM7, Brinson C8, Wang H9, Gallant J9,

Collins S9, McNicholl I9, Martin H9

1Midway Research, Fort Pierce, FL, USA; 2Gilead Korea, Seoul, Korea; 3Division of Infectious Diseases, ASST Papa Giovanni XXIII, Bergamo, Italy; 4Dupont Circle Physicians Group, Washington, DC, USA; 5Research Institute, McGill University Health Centre, Montreal, Canada; 6Division of Infectious Diseases, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy; 7Department of Infectious Diseases, Saint Louis Hospital, University Paris Diderot, France; 8Central Texas Clinical Research, Austin, TX, USA; 9Gilead Sciences, Inc., Foster City, CA, USA

Objectives: As life expectancy for people with HIV increases, optimizing antiretroviral therapy to fit the needs of older adults, including those with comorbidities and multiple medications, is paramount. B/F/TAF is a small single-tablet regimen with few drug-drug interactions, a high barrier to resistance and may provide a beneficial option for older patients.

Methods: In this pooled analysis of 4 international trials (Studies 1844, 1878, 4030 and 4449) of virologically suppressed (HIV-1 RNA<50 copies/mL), treatment-experienced adults, we evaluated the efficacy and safety of switching to B/F/TAF for participants ≥65 years. Primary endpoint was HIV-1 RNA<50 copies/mL at Week 48 as defined by the Food and Drug Administration Snapshot algorithm.

Results: 140 participants were age ≥65 years at study enrollment. Median age (Q1, Q3) was 68 years (66, 72), 14% were female, and 88% were White. Medical history at baseline was significant for diabetes 22%, hypertension 55%, cardiovascular disease 24% and dyslipidemia 59%. At W48, the proportion with HIV RNA<50 copies/mL was 92% (129/140). No participant had virologic failure. Most common adverse events (AEs) were nasopharyngitis and arthralgia (7% each). Eleven participants (8%) had a study drug related AE, all were either Grade 1 or Grade 2. There were no Grade 3-4 study drug-related AEs. Four participants had AEs that led to premature study drug discontinuation. Median changes from baseline in fasting lipids were: total fasting cholesterol (-7mg/dL), LDL (-2mg/dL), HDL (0mg/dL), triglycerides (-15mg/dL) and total cholesterol:HDL (-0.1). Median weight change was 1.0 kg (IQR -0.9, 3.0).

Conclusion: Switching to B/F/TAF in older adults was well tolerated and safe while maintaining high rates of virologic suppression through 48 weeks. These data support the use of B/F/TAF for treatment of adults ≥65 years who could benefit from a small tablet with few drug-drug interactions and an established safety profile.

Keywords: B/F/TAF elderly patients





Switching to DTG/3TC Fixed-Dose Combination (FDC) Is

Non-Inferior to Continuing a TAF-Based Regimen (TBR) in

Maintaining Virologic Suppression Through 96 Weeks

(TANGO Study)

J van Wyk1, F Ajana2, F Bisshop3, S De Wit4, O Osiyemi5, J Portilla6, J-P Routy7, C Wyen8, M Ait-Khaled1, M-C Nascimento1,

KA Pappa9, R Wang9, J Wright10, B Wynne9, M Aboud1, KY Smith9, S Kwon11

1ViiV Healthcare, Brentford, UK; 2Centre Hospitalier de Tourcoing, Tourcoing, France; 3Holdsworth House Medical Brisbane, Queensland, Australia; 4CHU St-Pierre, Brussels, Belgium; 5Triple O Research Institute PA, West Palm Beach, FL, USA; 6Hospital General Universitario de Alicante, Alicante Spain; 7McGill University Health Center, Montreal, QC, Canada; 8Praxis am Ebertplatz, Cologne, Germany; 9ViiV Healthcare, Research Triangle Park, NC, USA; 10GlaxoSmithKline, Stockley Park, UK; 11GlaxoSmithKline, Seoul, South Korea

Background: DTG/3TC 2-drug regimen (2DR) was non-inferior to a TAF-based 3/4DR through the

Week 48 primary endpoint in TANGO. Here we present Week 96 secondary endpoint analyses.

Methods: TANGO, a randomized, open-label, non-inferiority phase III study evaluates the efficacy and

safety of switching to once-daily DTG/3TC in HIV-1–infected, virologically suppressed (>6 months, no

prior virologic failure, no major NRTI or INSTI resistance) adults vs remaining on a TBR, over 148 weeks.

Participants were randomized 1:1, stratified by baseline third agent class: PI, NNRTI, INSTI. Week 96

analysis assessed non-inferiority with a 4% non-inferiority margin for Snapshot virologic failure (VF) and

8% for virologic success (VS; FDA Snapshot algorithm, intention-to-treat–exposed [ITT-E] population).

Results: 741 randomized/exposed participants (DTG/3TC: 369; TBR: 372). For Snapshot VF, switching

to DTG/3TC was non-inferior to continuing TBR at Week 96 in the ITT-E analysis: 0.3% vs 1.1%;

adjusted difference: −0.8% (95% CI: −2.0%, 0.4%) and superior to TBR in the per-protocol analysis:

0% vs 1.1%; adjusted difference: −1.1% (95% CI: −2.3, −0.0); P=0.044 (two-sided). Snapshot VS

was high in both arms and demonstrated non-inferiority (Table 1). Forty-four participants (5.9%) had

missing data in the Week 96 window due to COVID-19 impact. Zero participants on DTG/3TC and 3

(<1%) on TBR met protocol-defined VF with no resistance observed at failure. Overall adverse event

rates were similar between arms, with more drug-related AEs in the DTG/3TC arm (Table 1). TC,

LDL-cholesterol, and triglycerides improved significantly with DTG/3TC while HDL-cholesterol changes

significantly favored TBR, with no difference in TC/HDL-C ratio between arms. Decreases in GFR by

cystatin C were observed with a significantly lower decrease in the DTG/3TC arm; proximal tubular

function marker changes were small and similar across arms.

E-poster session


Week 96 study outcome by Snapshot analysis (ITT-E population), n (%)

DTG/3TC(N=369)

TBR(N=372)

HIV-1 RNA ≥50 c/mL (Snapshot virologic failure) 1 (0.3) 4 (1.1)

HIV-1 RNA <50 c/mL (Snapshot virologic success)a 317 (85.9) 294 (79.0)

No virologic data in Week 96 window 51 (13.8) 74 (19.9)

Week 96 virologic success for efficacy evaluable population,b n (%)

(N=353) (N=344)

HIV-1 RNA <50 c/mL (Snapshot virologic success) 317 (89.8) 294 (85.5)

Key safety results (safety population), n (%) (N=369) (N=371c)

Any AEs 324 (87.8) 325 (87.6)

AEs or death leading to withdrawal 21 (5.7) 4 (1.1)

Drug-related grade 2-5 AEsd 21 (5.7) 7 (1.9)

Serious adverse events 42 (11.4) (9.4)aSnapshot virologic success adjusted difference in (DTG/3TC) − TBR: 6.8% (95% CI: 1.4%, 12.3%). Estimates and confidence intervals were based on a stratified analysis using Cochran-Mantel-Haenszel weights adjusting for baseline third agent class.bSensitivity analysis excluding 16 and 28 participants in the DTG/3TC and TBR arms, respectively, because of no Week 96 HIV-1 RNA data due to COVID-19 pandemic impact. Snapshot virologic success adjusted difference in (DTG/3TC) − TBR: 4.3% (95% CI: −0.6%, 9.2%).c1 participant was excluded due to receiving a TDF-based regimen instead of a TAF-based regimend2 deaths (1 homicide and 1 unknown reason) both unrelated to treatment occurred in the DTG/3TC arm.

Table 1. Efficacy and Key Safety Results for the ITT-E and Safety Population

Conclusion: At Week 96, switching to DTG/3TC FDC was non-inferior to continuing a TAF-based

3/4DR in maintaining virologic suppression in HIV-1–infected ART-experienced adults. The safety

profile of DTG/3TC FDC was consistent with the DTG and 3TC respective labels. DTG/3TC 2DR offers a

robust switch option with durable efficacy, good safety and tolerability, and a high barrier to resistance

with zero protocol-defined VF through 96 weeks.

Keywords: 2-drug regimen; integrase strand transfer inhibitor; nucleoside reverse transcriptase

inhibitor; simplification; virologic suppression.


5-8, 2020; Virtual.




P-23 Epidemiology and social research

Assessment of disease burden and immunization rates for

vaccine-preventable diseases in people living with HIV:

The Korea HIV/AIDS Cohort study

Hye Seong1, Yunsu Choi2, Kyounghwan Ahn3, Jun-Yong Choi4,5, Shin-Woo Kim6, Sang Il Kim7, Mee-Kyung Kee8, Bo Youl Choi2,

Hak Jun Hyun1, Jin Gu Yoon1, Ji Yun Noh1,9, Hee Jin Cheong1,9, Woo Joo Kim1,9, Joon Young Song1,9

1Department of Internal Medicine, Korea University College of Medicine, Seoul; 2Department of Preventive Medicine, Hanyang University College of Medicine; 3Institute for Health and Society, Hanyang University, Seoul, Korea; 4Department of Internal Medicine, Yonsei University College of Medicine, Seoul; 5AIDS Research Institute, Yonsei University College of Medicine, Seoul; 6Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu; 7Department of Internal Medicine, Catholic University College of Medicine, Seoul; 8Division of Viral Disease Research, Korea Centers for Disease Control and Prevention, Cheongju, Korea; 9Asian Pacific Influenza Institute (APII), Seoul, Republic of Korea

Backgrounds: Prophylactic immunization is important for HIV-infected patients, but there is insufficient

data on the disease burden of vaccine-preventable diseases (VPD), vaccination rates or influencing

factors to be vaccinated.

Methods: The incidence and prevalence of VPDs were estimated in HIV-infected patients using the

Korea HIV/AIDS cohort database between 2006 and 2017. In addition, we evaluated the vaccination

rates and analyzed influencing factors to get vaccinated in HIV-infected patients through multilevel

analysis for the clinico-epidemiological factors, immune status, psychological status, etc. A

questionnaire survey was also conducted for experts whether they recommended vaccination to

HIV-infected patients or not.

Results: The incidence rates of HBV, herpes zoster, anogenital wart were 1.74, 7.38, and 10.85 per

1000 person-year, respectively. The prevalence of HBV and anogenital wart at enrollment was 4.8%

and 8.6%, respectively, which increased to 5.3% and 12.0% cumulatively by 2017. HBV (21.7% in 2008,

56.3% in 2013, and 75.4% in 2017) and pneumococcal (3.0% in 2015, 7.6% in 2016, and 9.6% in 2017)

vaccination rates increased by year, while annual influenza vaccination rates were similar by season

(33.9 - 34.4%).

In the multi-level analysis, influencing factors for pneumococcal and HBV vaccination were HIV viral

load and CD4 T-cell count, respectively. Influenza vaccination was related to male sex and the number

of antiretroviral therapy (ART) line, but not significantly associated with CD4 T-cell count or HIV viral

load. In questionnaire survey, most experts recommended HBV (92.9%), HAV (95.7%), pneumococcal

(81.4% for PCV13 and 75.4% for PPSV23) and influenza (100%) vaccination routinely, but they did not

for HPV (12.9%) and zoster (27.1%) vaccination.

E-poster session


Conclusion: CD4 T-cell count, HIV viral load, and the number of ART line were influencing factors to get

vaccination. There was a discordance between clinical practice and experts' opinions.

Keywords: HIV, disease burden, vaccination, risk factor, Korean HIV/AIDS cohort study




　　 New cases Incidence (/1,000 PY)

HBV 8 1.74

Herpes zoster 34 7.38

Anogenital wart prevalence 50 10.85

Table 1-1. Disease burden for HBV, Herpes zoster, anogenital wart: Incidence

　 TotalAt enrolment Cumulative until 2017

HBV Anogenital wart HBV Anogenital wart

Total 1,485 (100.0) 71 (4.8) 128 (8.6) 79 (5.3) 178 (12.0)

Age at enrollment

<30 297 (20.0) 7 (2.4) 40 (13.5) 7 (2.4) 62 (20.9)

30-39 401 (27.0) 15 (3.7) 39 (9.7) 16 (4.0) 49 (12.2)

40-49 399 (26.9) 24 (6.0) 35 (8.8) 29 (7.3) 48 (12.0)

　 ≥50 388 (26.1) 25 (6.4) 14 (3.6) 27 (7.0) 19 (4.9)

HBV, hepatitis B virus. Categorical variables were shown as numbers (percentage).

Table 1-2. Disease burden for HBV, anogenital wart: Prevalence

Diseases

Prevalence (%) 2

2008(n=484)

2013(n=1,242)

2017(n=1,485)

No. of loss to F/U 24 320 545

Hepatitis A

IgG anti HAV 47 (9.7) 198 (15.9) 250 (16.8)

Hepatitis B

Anti-HBV 1 345 (71.3) 730 (58.8) 875 (58.9)

　 Vaccination rate 3 25 (21.7) 108 (56.3) 49 (75.4)

1 including anti-HBs

2 cumulative prevalence 3 excluded participants of loss to follow up.

Table 2-1. Hepatitis vaccination rate by year

Diseases

Prevalence (%)

2015(n=932)

2016(n=938)

2017(n=940)

Pneumococcus 1 　　　

PCV13 90 (9.8) 108 (11.5) 114 (12.1)

PPV 23 33 (3.6) 52 (5.5) 62 (6.6)

　 PCV13 & PPV23 28 (3.0) 71 (7.6) 91 (9.7)

1 cumulative vaccination rate.

Table 2-2. Pneumococcal vaccination rate by year

E-poster session


Diseases

Seasonal prevalence (%)

2012-2013(n=928)

2013-2014(n=909)

2014-2015(n=917)

2015-2016(n=931)

2016-2017(n=931)

Influenza 　　　　　

　 Vaccination rate 315(33.9) 297(32.7) 314(34.2) 331(35.6) 320(34.4)

HBV, hepatitis B virus; HAV, hepatitis A virus; PCV, pneumococcal conjugate vaccine; PPSV, pneumococcal polysaccharide vaccine.

Table 2-3. Influenza vaccination rate by year

　

n (%) Seroconversion (%)

No. of enrolment

Cumulative vaccination

Seronegative Seropositive - → + + → -

Year 　　　　　　

2006 4 (0.3) 0 (0.0) - - - -

2007 200 (13.5) 29 (14.2) 11 (37.9) 18 (62.1) - -

2008 280 (18.8) 83 (17.1) 29 (34.9) 54 (65.1) 1 (2.2) 0 (0.0)

2009 155 (10.4) 125 (19.6) 51 (41.5) 72 (58.5) 0 (0.0) 2 (5.1)

2010 236 (15.9) 204 (23.3) 89 (45.4) 107 (54.6) 4 (4.7) 7 (8.2)

2011 187 (12.6) 275 (25.9) 116 (46.0) 136 (54.0) 2 (2.9) 1 (1.5)

2012 119 (8.0) 319 (27.0) 108 (41.7) 151 (58.3) 4 (8.9) 3 (6.7)

2013 61 (4.1) 340 (27.4) 99 (39.0) 155 (61.0) 4 (17.4) 1 (4.4)

2014 94 (6.3) 384 (28.7) 104 (38.2) 168 (61.8) 5 (10.9) 2 (4.4)

2015 64 (4.3) 413 (29.5) 116 (35.9) 207 (64.1) 4 (12.5) 0 (0.0)

2016 45 (3.1) 430 (29.8) 105 (37.1) 178 (62.9) 4 (18.2) 2 (9.1)

　 2017 41 (2.8) 446 (30.0) 101 (36.1) 179 (63.9) 4 (19.1) 1 (4.8)

Table 3-1. Seroprevalence and seroconversion rate for Anti-HBs antibody by year

　 Totalseroconversion (%)

p value- → + + → -

Initial CD4 T cell counts

<200 cells/mm3 168 (37.7) 15 (8.9) 8 (4.8)

0.943200-349 cells/mm3 122 (27.4) 9 (7.4) 6 (4.9)

≥350 cells/mm3 153 (34.3) 8 (5.2) 5 (3.3)

Initial HIV viral load

<50 copies/mL 20 (4.5) 2 (10.0) 0 (0.0)0.266

≥50 copies/mL 422 (94.6) 30 (7.1) 19 (4.5)

Age at enrolment

18-49 year 361 (80.9) 29 (8.0) 17 (4.7)0.894

　 ≥50 year 85 (19.1) 3 (3.5) 2 (2.4)

Table 3-2. Factors associated with seroconversion rate for Anti-HBs antibody

296

　To

tal

(n=1,2

28)

Influe

nza

vacc

inat

ion

p-va

lue

Odd

s R

atio

(95%

Con

fide

ntia

l Int

erva

l)

　　

Yes

(n=

301)

No

(n=927)

null

Indi

vidu

al le

vel

Hos

pita

l lev

elM

ultile

vel

Indi

vidu

al le

vel

　　

Age

41.

3 ±

12.

542.1

± 1

2.5

41.

0 ±

12.5

0.1

951.

00(0

.99-

1.02

)1.

00(

0.9

9-1.

02)

Sex

(m

ale)

1,143

(93.

1)286(

25.0

)857

(75.

0)0.1

271.

92(1

.01-

3.66

)1.

94(

1.0

2-3.

70)

Mar

ital

sta

tus

Sin

gle

697

(56.

8)170(

24.4

)527

(75.

6)

0.0

04

ref

ref

Mar

ried

298

(24.

3)82

(27.

5)216

(72.

5)1.

23(0

.79-

1.92

)1.

24(

0.8

0-1.

94)

Div

orce

d /

bere

aved

/ se

para

ted

141

(11.

5)40

(28.

4)101

(71.

6)1.

43(0

.86-

2.39

)1.

44(

0.8

6-2.

41)

Oth

ers

92(7

.5)

9(9

.8)

83(

90.2

)0.

40(0

.18-

0.89

)0.

41(

0.1

8-0.

89)

CD

4 T

cell

coun

ts (N

adir)

<200

326

(26.

5)81

(24.

8)245

(75.

2)

0.9

71

0.89

(0.6

1-1.

30)

0.88(

0.6

0-1.

30)

200-

350

393

(32.

0)97

(24.

7)296

(75.

3)0.

94(0

.67-

1.34

)0.

94(

0.6

6-1.

33)

≥350

509

(41.

5)123(

24.2

)386

(75.

8)re

fre

f

HIV

viral

load

(Pea

k)

<50

464

(37.

8)121(

26.1

)343

(73.

9)0.3

20re

fre

f

≥50

764

(62.

2)180(

23.6

)584

(76.

4)0.

79(0

.57-

1.10

)0.

79(

0.5

7-1.

10)

Num

ber

of A

RT

line

3.5

± 2

.44.1

± 2

.43.

2 ±

2.3

<0.0

001

1.16

(1.0

9-1.

24)

1.16(

1.0

9-1.

24)

Com

orbi

dities

407

(33.

1)114(

28.0

)293

(72.

0)0.0

451.

01(0

.73-

1.41

)1.

01(

0.7

2-1.

40)

Hos

pita

l lev

el

No.

of

beds

<1,0

00

300

(24.

4)68

(22.

7)232

(77.

3)

<0.0

001

ref

ref

<1,5

00

583

(47.

5)185(

31.7

)398

(48.

3)0.7

1(0.

17-3.0

6)0.

81(

0.2

0-3.

35)

　　

≥1,5

00

345

(28.

1)48

(13.

9)297

(86.

1)0.1

9(0.

03-1.0

6)0.

19(

0.0

4-1.

03)

Bet

wee

n co

mm

unity

varian

ce　

　　

　1.

552

01.4

529

1.6

604

1.55

75

PC

V (Perc

enta

ge c

hang

e in

var

ianc

e)　

　　

　-

-6.

39%

6.9

8%0.

35%

Bet

wee

n co

mm

unity

varian

ce (S.E

.)0.

699

20.6

615

0.7

909

0.76

14

Bet

wee

n co

mm

unity

varian

ce (p-

valu

e)<0

.0001

<0.0

001

0.0

01

<0.0

001

Mod

el f

it-2 R

es L

L58

21.

98589

9.6

658

52.

955929

.34

ICC

(In

tra-

clas

s co

rrel

atio

n)　

　　

　0.

320

80.3

066

0.3

356

0.32

15

Tabl

e 4-

1. M

ulti-le

vel a

naly

sis:

Inf

luen

cing

fac

tors

for

Influe

nza

vacc

inat

ion

297

　　

Tota

l(n

=1,1

58)

Pne

umoc

occa

l vac

cina

tion

p-va

lue

Odd

s R

atio

(95%

Con

fide

ntia

l Int

erva

l)

　Y

es (n=

248

)N

o (n

=910

)nu

llIn

divi

dual

leve

lH

ospi

tal l

evel

Mul

tile

vel

Indi

vidu

al le

vel

　　

　　

Age

41.

3 ±

12.5

41.9

± 1

1.5

41.1

± 1

2.7

0.3

501.0

1(0.

99-1.0

3)1.

01(0

.99-

1.03

)

Sex

(m

ale)

1,076

(92.

9)22

9(21

.3)

847(

78.7

)0.6

880.6

3(0.

33-1.2

2)0.

63(0

.33-

1.22

)

Mar

ital s

tatu

s

Sin

gle

658

(56.

8)14

9(22

.6)

509(

77.4

)

0.0

08

ref

ref

Mar

ried

283

(24.

5)65(

23.0

)21

8(77

.0)

0.7

7(0.

46-1.2

8)0.

77(0

.47-

1.29

)

Div

orce

d /

bere

aved

/ se

para

ted

130

(11.

2)28(

21.5

)10

2(78

.5)

0.7

2(0.

39-1.3

4)0.

72(0

.39-

1.35

)

Oth

ers

87(7

.5)

6(6.9

)81(

93.

1)0.3

4(0.

13-0.9

0)0.

34(0

.13-

0.89

)

CD

4 T

cell

coun

ts (N

adir)

<200

316

(27.

3)64(

20.2

)25

2(79

.8)

0.0

14

0.9

2(0.

60-1.4

2)0.

92(0

.59-

1.42

)

200

-350

375

(32.

4)65(

17.3

)31

0(82

.7)

0.7

0(0.

46-1.0

6)0.

70(0

.46-

1.06

)

≥35

0467

(40.

3)11

9(25

.5)

348(

74.5

)re

fre

f

HIV

vira

l loa

d (P

eak)

<50

430

(37.

1)12

0(27

.9)

310(

72.1

)<0

.0001

ref

ref

≥50

728

(62.

9)12

8(17

.6)

600(

82.4

)0.6

3(0.

43-0.9

2)0.

63(0

.43-

0.92

)

Hos

pita

l lev

el

No.

of

beds

<1,0

00290

(25.

0)43(

14.8

)24

7(85

.2)

<0.0

001

ref

ref

<1,5

00551

(47.

6)15

8(28

.7)

393(

71.3

)1.4

4(0.3

1-6.6

1)1.

59(0

.36-

7.05

)

　　

≥1,

500

317

(27.

4)47(

14.8

)27

0(85

.2)

　　

0.5

8(0.0

9-3.5

9)0.

55(0

.09-

3.47

)

Bet

wee

n co

mm

unity

varian

ce　

　　

　1.6

222

1.558

61.

7377

1.6

386

PC

V (Per

cent

age

chan

ge in

var

ianc

e)　

　　

　-

-4%

7%

1%

Bet

wee

n co

mm

unity

varian

ce (S.E

.)0.7

044

0.681

00.

7913

0.7

561

Bet

wee

n co

mm

unity

varian

ce (p-

valu

e)<0

.000

10.0

05

<0.0

001

0.01

0

Mod

el f

it-2 R

es L

L579

2.84

5888.

745806

.79

590

2.22

ICC

(In

tra-

clas

s co

rrel

atio

n)　

　　

　0.3

305

0.321

70.

3459

0.3

327

Tabl

e 4-

2. M

ulti-le

vel a

naly

sis:

Inf

luen

cing

fac

tors

for

Pne

umoc

occa

l vac

cina

tion

298

　　

Tota

l(n

=962)

Hep

atitis

B v

acci

nation

p-va

lue

Odd

s R

atio

(95

% C

onfide

ntia

l Int

erva

l)

　Y

es (n=

405)

No

(n=55

7)nu

llIn

divi

dual

leve

lH

ospi

tal l

evel

Mul

tile

vel

Indi

vidu

al le

vel

　　

　　

Age

41.

1 ±

12.

239.1

± 1

1.7

42.

6 ±

12.4

<0.0

001

0.98(

0.9

7-1.

00)

0.9

8(0.

97-1.0

0)

Sex

(m

ale)

895(

93.

0)381(

42.6

)514

(57.

4)0.2

81

0.92(

0.5

1-1.

65)

0.9

2(0.

51-1.6

5)

Mar

ital

sta

tus

Sin

gle

559(

58.

1)269(

48.1

)290

(51.

9)

<0.0

001

ref

ref

Mar

ried

242(

25.

2)82

(33.

9)160

(66.

1)0.

78(

0.5

1-1.

20)

0.7

8(0.

51-1.2

0)

Div

orce

d /

bere

aved

/ se

para

ted

112(

11.

6)41

(36.

6)71(

63.4

)0.

81(

0.4

8-1.

36)

0.8

1(0.

48-1.3

5)

Oth

ers

49(

5.1

)13

(26.

5)36(

74.5

)0.

79(

0.3

8-1.

65)

0.8

0(0.

38-1.6

8)

CD

4 T

cell

coun

ts (N

adir)

<200

256(

26.

6)105(

41.0

)151

(59.

0)

<0.0

001

0.88(

0.6

1-1.

27)

0.8

8(0.

61-1.2

7)

200

-350

301(

31.

3)100(

33.2

)201

(66.

8)0.

54(

0.3

9-0.

77)

0.5

4(0.

39-0.7

6)

≥35

0405(

42.

1)200(

49.4

)205

(50.

6)re

fre

f

HIV

vira

l loa

d (P

eak)

<50

370(

38.

5)171(

46.2

)199

(53.

8)0.0

41

ref

ref

≥50

592(

61.

5)234(

39.5

)358

(60.

5)0.

87(

0.6

4-1.

20)

0.8

8(0.

64-1.2

0)

Num

ber

of A

RT

line

3.4 ±

2.2

3.1

± 2

.23.

5 ±

2.2

0.0

05

0.96(

0.9

0-1.

02)

0.9

6(0.

90-1.0

2)

Hos

pita

l lev

el

No.

of

beds

<1,0

00244(

25.

3)92

(37.

7)152

(62.

3)

0.1

69

ref

ref

<1,5

00448(

46.

6)189(

42.2

)259

(57.

8)0.

59(0

.16-

2.16

)0.5

2(0.

14-1.9

6)

　　

≥1,

500

270(

28.

1)124(

45.9

)146

(54.

1)1.

25(0

.28-

5.52

)1.2

5(0.

27-5.6

8)

Bet

wee

n co

mm

unity

varian

ce　

　　

　1.1

519

1.21

86

1.3

412

1.390

6

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E-poster session


Question 0. How many people living with HIV are you following?

< 10 7 (10.0)

10-49 29 (41.4)

≥ 50 34 (48.6)

Part 1. HBV vaccinationQuestion 1-1. Do you routinely administer the hepatitis B vaccine to people living with HIV?

Yes 65 (92.9)

No 5 (7.1)

Question 1-2. If you routinely administer the hepatitis B vaccine to people living with HIV, what range of CD4 T cell counts do you administer?

CD4 T cell count ≥200 cells/mm3 24 (36.9)


Regardless of CD4 T cell count 29 (44.6)

Question 1-3. If you routinely administer the hepatitis B vaccine to people living with HIV, do you give HIV patients a high dose (double-dose) for hepatitis B vaccination?

Yes 1 (1.5)

No 64 (98.5)

Question 1-4. If you routinely administer the hepatitis B vaccine to people living with HIV, do you check whether antibodies are produced after completing vaccination?

Yes 58 (89.2)

No 7 (10.8)

Part 2. HAV vaccinationQuestion 2-1. Do you routinely administer the hepatitis A vaccine to people living with HIV?

Yes 65 (92.9)

No 5 (7.1)

Question 2-2. If you routinely administer the hepatitis A vaccine to people living with HIV, what range of CD4 T cell counts do you administer?




Question 2-3. If you routinely administer the hepatitis A vaccine to people living with HIV, do you check whether antibodies are produced after completing vaccination?

Yes 32 (49.2)

No 33 (50.8)

Part 3. Pneumococcal vaccinationQuestion 3-1. Do you routinely administer the PCV 13 to people living with HIV?

Yes 57 (81.4)

No 13 (18.6)

Table S1. 70 Expert survey on vaccination to people living with HIV




Question 3-2. If you routinely administer the PCV 13 to people living with HIV, what range of CD4 T cell counts do you administer?




Question 4-1. Do you routinely administer the PPSV 23 to people living with HIV?

Yes 52 (75.4)

No 17 (24.6)

Question 4-2. If you routinely administer the PPSV 23 to people living with HIV, what range of CD4 T cell counts do you administer?




Part 4. Influenza vaccinationQuestion 5. Do you administer the influenza vaccine annually for people living with HIV?

Yes 70 (100.0)

No 0 (0.0)

Part 5. HPV vaccinationQuestion 6. Do you routinely administer the HPV vaccine to people living with HIV?

Yes 9 (12.9)

No 61 (87.1)

Part 6. Herpes zoster vaccinationQuestion 7-1. Have you ever given a Herpes zoster vaccine to an HIV patient over 50?

Yes 19 (27.1)

No 48 (68.6)

Routinely administer 3 (4.3)

Question 7-2. If you routinely administer the Herpes zoster vaccine to people living with HIV, what range of CD4 T cell counts do you administer?



HIV, human immunodeficiency virus; HBV, hepatitis B virus; HAV, hepatitis A virus; PCV, pneumococcal conjugate vaccine; PPSV, pneumococcal polysaccharide vaccine; HPV, human papillomavirus.Categorical variables were shown as numbers (percentage).

E-poster session


의료기관감염인상담사업 2015 2016 2017 2018 2019

내원

감염인

전체 내원감염인 5927 6629 7236 8873 9978

성별

N (%)

male490

(92.6)

6143

(93)

6708

(93)

8206

(92.5)

9247

(92.7)

female 437(7.4) 486(7) 528(7) 667(7.5) 723(7.3)

나이

N (%)

0~9 2(0) 　0(0) 　0(0) 2(0) 2(0)

10~19 48(0.8) 37(0.5) 34(1) 35(0.4) 27(0.3)

20~29996

(16.8)

1231

(18.5)

1356

(19)

1530

(17.4)

1635

(16.4)

30~391448

(24.4)

1605

(24)

1678

(23)

2064

(23.5)

2457

(24.6)

40~491621

(27.3)

1735

(26)

1876

(26)

2160

(24.6)

2409

(24.1)

50~591111

(18.7)

1295

(20)

1419

(20)

1792

(20.4)

2064

(20.7)

60 이상701

(11.8)

724

(11)

649

(9)

1189

(13.6)

1384

(13.9)


의료기관감염인상담사업 지표로 본 감염인 건강관리 현황

: 2015 년~2019 년 시계열 분석

최재필1, 이정휘 1, 서아영 1, 의료기관감염인상담사업단 2

1 서울의료원 감염내과, 226 개 의료기관감염인상담사업 사업책임자 및 상담간호사, 코디네이터

배경: 의료기관감염인상담사업은 2006 년부터 본사업을 시작하여 2020 년 14 년차로 26 개의 의료기관에서 수행되고

있다. 의료기관에서 HIV 관련 상담간호사의 전문적인 상담을 통해 감염인의 질병적응과 건강관리를 돕고 심리적 안정을

도모하여 복약 순응도를 높이고 궁극적으로 감염인의 삶의 질 향상과 HIV 전파 예방을 위하여 시행되고 있다. 자료는 1

년 단위로 보고서형태로 작성되고만 있어 본 연구에서는 최근 5 개년도의 보고서 자료를 이용하여 지표변화를 시계열 분

석하고자 한다.

방법: 2015 년~2019 년 상담사업 최종보고 자료와 2020 년 사업중간보고 자료를 이용하여 기본적인 인구학적 지표,

사업지표인 복약순응도, 우울ㆍ불안 중재율, 바이러스 미검출을 비교하였다.

결과: 2015 년 5927 명(전국 생존감염인 대비 56.4%)에서 증가하여 2020 년 9,978 명(72%)의 감염인이 상담사업

의료기관을 방문하고, 그중 89.9%의 감염인이 상담을 이용하고 있다.




의료기관감염인상담사업 2015 2016 2017 2018 2019

급여

유형

N (%)

의료보험 4810(81.2) 5422(81.8) 5995(83) 7456(84) 8458(84.7)

급여·차상위 1071(18.1) 1135(17.1) 1155(16) 1333(15) 1405(14.1)

일반 46(0.8) 72(1) 90(1) 84(0.9) 115(1.2)

후불제 이용(%)4055

(84.3)

4725

(87.1)

5340

(89)

6537

(87.7)

7601

(89.9)

상담인원(%)4656

(78.6)

5964

(85.9)

6486

(89.6)

7561

(85.2)

8969

(89.9)

신규감염인

신규감염인 703 723 675 712 735

해당연도 확진인원(%) 584(83) 616(85.2) 570(84.4) 624(87.5) 660(89.4)

상담명수 N (%) 639(90.9) 678(93.8) 635(94.1) 658(92.4) 695(94.6)

항레트로바이러스제 투약현황은 2015 년 95.6%, 2017 년이후로는 99%이상 항레트로바이러스제를 복약 중이다. (지

표 1)복약순응도 유지 감염인의 비율은 2015 년 42.4%에서 2019 년 81.9%로 증가하였으며 복약순응도 측정 감염인

중 순응도 90%이상 감염인의 비율은 2015 년 92.6%에서 2019 년 97.5% 까지 증가추세에 있었다. (지표 2)불안은

기관수의 증가에 따라 조사자의 명수가 증가하였으나, 불안 중재 대상인 52 점 (약간 높은 수준 이상) 비율은 2015 년

33.3%에서 2019 년 25.4%로 감소하였다. 우울 또한 기관수의 증가에 따라 조사자의 수가 증가하였으나, 우울 중재 대

상인 10 점(중간 정도 수준, 심한 수준)은 2015 년 31.9%에서 2019 년 22.8%로 감소하고 있었다. 2019 년부터 (지

표 3)바이러스 억제율 조사를 시행한 결과 2019 년은 40copies/ml 기준 93.8%, 1000copies/ml(UNAIDS 기준)

97.4%였고 2020 년 중간보고서 결과는 각각 93.2%, 97.8%였다. ※2019 년도 RNA 자료는 24 개 의료기관 자료임

결론: 의료기관감염인상담사업의 수행으로 대상자수가 꾸준히 증가하여 국내 생존감염인 대비 72%의 감염인들이 이용

하고 복약순응도 중재, 우울불안 중재를 시행해오고 있다. 사업수행의료기관을 이용하는 99.4%의 감염인이 안정적으로

투약 중이며 97.4%의 감염인이 바이러스 억제 유지 중이다. 지표 결과에 대한 추가적 분석이 필요하다.

E-poster session



남성 동성애자 대상 성 건강 결정 영향요인

양혜진

건양대학교 간호대학 간호학과

연구배경: 우리나라는 2004 년 성매매특별법이 시행되고, 과거 유교문화에서 개방적인 성문화로 변모하면서 자유로운

성적 교류가 확산되면서 성 매개 감염병의 발생빈도가 높아지고, 그 중 바이러스성 성 매개 감염병은 지속적으로 증가하

는 추세에 있으며, 매질, 임질과 같은 성 매개 감염병은 HIV 의 전파 및 감염의 위험성을 2-3 배 증가시킨다.

우리나라는 주로 남성 동성애자들 간의 성 접촉을 통해 확산되는 1 단계이며, HIV/AIDS 유병률은 0.1%로, 다른 나라

에 비해서 유병율이 낮은 편이다. 하지만, 국가의 치료비 지원정책에 있어서는 경제적 장벽이 낮음에도 불구하고 남성 동

성애자의 HIV 수검율은 2008 년 22%로낮은 편이다.

이에 HIV 감염 및 성매개감염병 취약군인 남성 동성애자 대상으로 성 건강 자기결정에 영향요인으로 예측되는 주요변수

인 성 건강지식, 성태도, 성정체성, 성적 자율성을 중심으로 이 요인들이 남성 동성애자 대상의 성 건강 자기결정성에 미

치는 영향요인을 파악함으로써 남성 동성애자 대상 상담 및 교육프로그램의 기초자료로 활용하고자 한다.

연구방법:이반시티(IVANCITY) 홈페이지에 접속하는 남성 동성애자 대상으로 성 건강지식, 성 태도, 성 정체성, 성적 자

율성, 성 건강 자기결정의 정도를 알아보고, 그들 간의 관계를 살펴보면서, 성 건강 자기결정서에 영향을 주는 요인을 알

아보기 위한 서술적 단면조사연구이다.

연구결과: 총 217 명에 대해 분석하였으며, 대상자의 212 명(97.7%)가 남성이었으며, 대상자의 연령은 평균 연령은

37.42±9.95 세였다. 이변량 분석에서 성 지식에 영향을 미친 요인으로는 교육수준과 성 정체감에 통계적으로 유의한

차이가 있는 것으로 나타났고, 성 허용성에서는 거주지역, 성 태도에서는 도시지역유무, 성 정체감, 성 자율성과 성 건강

결정성에서 성 정체성에서 통계적으로 유의한 차이가 있는 것으로 나타났다. 남성 동성애자 대상으로 성 건강 결정에 영

향을 미치는 요인을 확인하기 위해 성 정체성과 성 자율성 단계적 다중회귀분석을 실시한 결과, 성적 자율성이 54%의

설명력을 보여주었다.

결론: 남성 동성애자 대상으로 성 건강 결정에 영향을 미치는 요인으로 성적 자율성이 영향을 미치는 것으로 확인되었다.

추후 이들 대상으로 성교육 프로그램 개발 및 운영 시 필요한 교육전략의 기초자료를 마련할 수 있을 것으로 생각된다.

Keywords: 지식, 태도, 자율성, 성 건강 결정, 남성 동성애자





Stuck in Neutral: Identifying opportunities to make

progress in addressing HIV-related stigma and other

emotional and psychosocial unmet needs among people

living with HIV in South Korea

Sungshin Kwon1, Benjamin Young2, Ki Hyon Kim3, Piotr Budnik4, Dannae Brown5, Nathalie Dang3, Chinyere Okoli4, Patricia de

los Rios6

1GSK Healthcare, Seoul Korea; 2ViiV Healthcare Research Triangle NC US; 3ViiV Healthcare, Singapore; 4ViiV Healthcare Brentford Middlesex England; 5ViiV Healthcare Abbotsford Australia; 6ViiV Healthcare Quebec Canada

Background: Much progress has been made in HIV prevention and control in South Korea in recent

years. During 2017, there were 1,307 new diagnoses of HIV, down from a peak of 3,496 in the year

2000. Of the estimated 25,557 people living with HIV (PLHIV) in the country in 2017, HIV-specific

mortality rate in that year was less than 1%, attesting to high uptake and utilization of antiretroviral

therapy (ART). Yet, major barriers to HIV care remain, including HIV stigma and homophobia. Delivering

HIV care in a manner that helps PLHIV rise above these challenges is critical to ensuring retention in

care, adherence, and improved quality of life. The World Health Organization’s definition of health as

well as the proposed “fourth 90” target both go beyond merely ensuring “absence of disease or

infirmity”, rather, they focus on promoting health-related quality of life. We investigated the extent of

physical, emotional, and psychosocial challenges of ART among PLHIV in South Korea.

Methods: We analyzed self-reported data for 50 PLHIV aged 18+ years on ART in South Korea who

participated in the 2019 Positive Perspectives study, an international, web-based survey conducted in a

total of 25 countries. Data were collected regarding ART-related experiences and perceptions, including

whether participants had ever disguised/hidden their HIV medication to avoid sharing their HIV status,

perceived comfort with sharing their HIV status, individuals they had shared their HIV status with, as

well as reasons for ever refusing to share. Participants were also asked a series of questions regarding

perceptions towards daily oral intake of ART, number of times they missed ART within the past month,

and reasons for missing. We computed overall prevalence estimates for South Korea to quantify the

diverse treatment challenges. We further examined differences in stigma experiences by sexual

orientation in South Korea and contrasted that with other Asian countries in the Positive Perspectives

study (Japan, n = 75; Taiwan, n = 55; China, n = 50). Prevalence differences in markers of perceived

structural stigma between PLHIV identifying as heterosexual vs as homosexual/other sexual orientation

E-poster session


were calculated; larger differences were taken as greater stigma among the disadvantaged group.

Prevalence estimates were compared with c2 tests at p<0.05.

Results: Mean age of participants in South Korea was 36.3 (SD=11.2) years; mean HIV duration was 5.2

(SD=5.0) years. Overall, 58%[29/50] identified as men and 68%[34/50] as heterosexual. Of all

participants, 84%[42/50] had ever disguised their HIV medications in the past 6 months, and

62%[31/50] indicated they would be very anxious if someone were to see their HIV medication.

Furthermore, 46%[23/50] experienced side effects from their HIV medicines, 56%[28/50] had difficulty

swallowing pills, and 62%[31/50] admitted that the overall impact of HIV on their life was negative.

Regarding emotional challenges related to daily ART within the overall South Korean sample,

48%[24/50] felt it limited their life, 56%[28/50] were stressed by it, 58%[29/50] said it reminded them

of their HIV, 44%[22/50] associated it with bad memories, 46%[23/50] were worried of forgetting to

take their ART as prescribed, and 56%[28/50] were concerned that taking HIV medicines every day

increased the chances of someone knowing their HIV status. Disparities existed in perceived stigma by

sexual orientation in South Korea; PLHIV identifying as homosexual/other sexual orientation were eight

times more likely than those identifying as heterosexual to report they had ever refused to share their

HIV status because "I was worried about my physical safety/potential violence" (25%[4/16] vs

3%[1/34], p = 0.015). They were also more likely to be concerned (2-3 times higher, all p<0.05) about

being treated differently (94%[15/16] vs 44%[15/34]), of losing their friendships from sharing their

status (88%[14/16] vs 26%[9/34]), of losing their jobs if their HIV status became known (69%[11/16] vs

24%[8/34]), that sharing their HIV status might affect their romantic relationships (50%[8/16] vs

15%[5/34]), and of being excluded from social activities because of their HIV (63%[10/16] vs

29%[10/34]). Interestingly, none of these differences were statistically significant by gender (men vs

women). For each of these markers of perceived structural stigma, the inequality by sexual orientation

was highest in South Korea compared to the other countries in the Asian region. Of all participants in

South Korea, 70%[35/50] were interested in a nondaily ART regimen.

Conclusion: Physical, emotional, and psychosocial challenges are common among PLHIV. Perceived

stigma was prominent along the lines of sexual orientation, but not gender. Participants identifying as

homosexual/other sexual orientation reported disproportionately higher stigma experience compared to

heterosexual, and this gap was wider in South Korea than other Asian countries surveyed. It is

important to recalibrate social norms regarding HIV stigma and homophobia. In addition, treatment

alternatives that make HIV a less conspicuous part of the lives of PLHIV (e.g., nondaily regimens) may

reduce perceived disruption of their lives from HIV or HIV treatment, thereby potentially improving

health-related quality of life as espoused in the “fourth 90” target.

Keywords: Antiretrovirals, Difficulty swallowing, Privacy, Quality of life, Stigma




Figure 1. Percentage of participants in South Korea who reported various treatment-related

perceptions, attitudes, and behaviors (N = 50)

E-poster session


Figure 2. Indicators of perceived stigma, stratified by sexual orientation, among people living with

HIV in South Korea (N = 50)

Note: Asterisks indicate p < 0.05 based on chi-squared tests




Figure 3. Extent of inequality by sexual orientation (absolute prevalence differences) for indicators

of perceived structural stigma and privacy/confidentiality concerns

2020 대한에이즈학회

학술대회인 쇄

발 행

발 행 처

편 집 제 작

2020년 11월 20일

2020년 11월 20일

대한에이즈학회서울시 서초구 서초대로 74길 23서초타운트라팰리스 806Tel: 02-3487-1755, Fax: 02-6499-1755E-mail: [email protected]: www.kosaids.or.kr

(주) 캡스톤 그룹 (CAPSTONE Group)(04147) 서울특별시 마포구 백범로 31길 21 본관6층Tel : 02-6010-8500E-mail : [email protected]

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