OC-66 Socio-demographic, clinical and therapeutic features of persons with HIV (PWH) currently in care in Italy: data from the ICONA cohort

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Background Aim of this study is to characterize socio-demographic, clinical and therapeutic features of PWH currently in care in 61 Italian Infectious Diseases centers belonging to the ICONA cohort. Material and Methods All the PWH enrolled in ICONA with at >= follow-up in 2022–2023 are included. Data from the ICONA database including age, sex, nation of birth, scholarity, employment, mode of HIV transmission, last CD4 and HIV-RNA, ongoing ART line and regimens, and comorbidities are analyzed. In case of multiple visits only the more recent one is considered. Results A total of 10900 PWH are included; 2173 (19.9%) are females, median age is ¬49 years (IQR: 40–58 ), 1962 (18.0%) are > 60 years old, 2072 (19.0%) are born outside Italy. Sexual contacts are the most frequent mode of HIV transmission: 4947 (45.3%) by MSM, 4334 (39.7%) by heterosexual route. Median time from HIV diagnosis is 8.4 years (IQR: 3.9–13.9); 1531/10900 (14%) PWH have an AIDS diagnosis . Current data on scholarity and employment are reported among the 1622 PWH enrolled in 2022–23: 154 (9.7%) have university degree, 32 (2%) have primary school degree. 54.2% PWH have a stable employment, 12,5% are unemployed. A total of 190 (11.7% of the 1622 enrolled in 2022–23) are current recent (within one year) seroconverters. A total of 541 (5.0%) have CD4<200 cells/mL, 1381 (12.7%) < 350/mL, 8112 (75.5%) >500cells/mL. Median CD4 is 722 cells/mL. HIV-RNA is <50 copies/mL in 9601 (89.2%), <200 copies/mL in 10006 (91.8%), >100,000 copies/mL in 311 (2.8%) . 276 (2.5%) are affected by cardiovascular disease, 70 (0.6%) by non AIDS malignancies. Total cholesterol >200/ml is reported in 3237 (29.6%), and triglicerydes>200/mL in 1167 (10.7%). As refers to antiretroviral therapy (ART), 149 (1.3%) are naives, 2800 (25.7%) are at their first regimen, 2291 (21.0%) at 2nd and 5660 (51.9%) at >=3rd one (table 1a and b). Considering all lines of ART, BIC/FTC/TAF is the more frequent regimen (in 28.4% of 10751 on ART, 3TC/DTG the second one (22.7%), 471 (4.4%) are on treatment with Long-Acting agents. (figure 1). Conclusions PWH currently in care in Italy are mostly men, aged 60 or older in one fifth of cases, born outside of Italy in another fifth. The majority are at their third or more line of therapy. 3-drug INSTI based regimen are given in a large majority, and dual regimen are the second more used one. More than 90% are not sexually transmitters as HIVRNA is below 200 copies/mL; their immunologic condition is in normal range in two third of them. We may conclude that HIV is becoming a chronic long-lasting non infective illness in those who are in care. Still 12% of new enrolments acquired HIV infection less than one year before. These data demonstrate that there are still individuals who get infected now, either by subjects unknown to be HIV positive or by those missing care and/or therapy.

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