1343. Body fat and metabolic complications in youth with perinatally-acquired HIV

Abstract Background The role of obesity on long-term metabolic complications remains poorly understood in youth living with perinatally-acquired HIV (YPHIV). Methods PHACS Adolescent Master Protocol (AMP) study enrolled YPHIV from 2007-2009 across 15 U.S. sites, including Puerto Rico. We included aged 7-19 yr body composition data assessed by whole-body dual energy x-ray absorptiometry (DXA) at baseline and 2 years later. Metabolic outcomes homeostatic assessment insulin resistance (HOMA-IR) non-high-density lipoprotein cholesterol (non-HDL-C). fit linear regression models using generalized estimating equations to assess the association % change trunk fat over 3, adjusted for potential confounders (age, race: Black vs. non-Black, Tanner stage, sex, family history, CD4, viral load, ART). Results 232 participants had a second DXA either HOMA-IR or non-HDL-C measured year 2. Participant characteristics first were: median (Q1, Q3) age 12 (9, 14) 70% Black, CD4 count 714 cells/mm3; RNA < 400 copies/mL; 72% protease inhibitor-, 25% non-nucleoside reserve transcriptase 3% integrase strand transfer inhibitor-based ART. increase total percentage was 5.41% 4.47%, respectively. figure shows distributions non-HDL-C. In both unadjusted analyses (Table), every 1% years, we observed 0.002 (95%CI -0.0, 0.005) higher log10 which equals ∼ 0.5% HOMA-IR. For (mg/dL) 0.19 0.03, 0.35) 0.65 0.12, 1.19) higher, respectively, models. were similar but slightly attenuated when additionally Figure:HOMA-IR non-HDL baseline, 2, 3Table:Unadjusted assessing percent ¹Adjusted (years), sex (male vs female), race (Black non-Black), stage (2, 4-5 1), history diabetes cardiovascular disease (yes, not known no), (≤350 >350 cells/mm³), load (≥400 <400 copies/mL). ²Adjusted copies/mL), ARV exposure (PI without NNRTI, NNRTI PI other). Conclusion Increases adiposity time may lead downstream decreased sensitivity dyslipidemia YPHIV. This is clinically significant, as even small increases have been associated all-cause mortality non-diabetic HIV-uninfected adults. Long-term follow-up warranted. Disclosures Mitchell E. Geffner, MD, Adrenas: Advisor/Consultant|Adrenas: Honoraria|Ascendis: Advisor/Consultant|Ascendis: Honoraria|Aventria: Honoraria|Eton: Advisor/Consultant|Eton: Honoraria|ICON Clinical Research, LLC/Aeterna Zentaris: Advisor/Consultant|ICON Honoraria|McGraw-Hill: Royalties|Neurocrine Biosciences: Grant/Research Support|Novo Nordisk: Support|Nutritional Growth Solutions Ltd: Advisor/Consultant|Nutritional Honoraria|Pfizer, Inc.: Advisor/Consultant|Pfizer, Honoraria|Spruce Support|UpToDate: Royalties Grace A. McComsey, Gilead, Merck, ViiV, Janssen, Theratechnologies: Advisor/Consultant.