1032. More Similar than You May Think: A Comparison of Perinatally vs. Behaviorally Infected Young Adults Living with HIV

Background Many perinatally infected people living with HIV (PLWH) have reached adulthood. It is important to understand differences in key outcomes between this group and those who were behaviorally infected with HIV. We sought to determine if there were differences in HIV-RNA viral load, antiretroviral therapy (ART) adherence, substance use, comorbidities, and healthcare engagement between the two groups. Methods This retrospective study was performed at Northwell’s Center for AIDS Research and Treatment in Manhasset, NY from November 1, 2016 to December 31, 2018. The sample size included 38 perinatally infected PLWH and 51 behaviorally infected PLWH. Data were extracted from the electronic medical record. The primary endpoint was HIV-RNA viral load. Secondary endpoints included ART adherence, comorbidities, CD4 counts, number of missed HIV care appointments, self-reported sexual activity, and substance use. Comparisons of the two groups were conducted using the Wilcoxon rank sum test and Fisher’s exact test. Results Perinatally infected PLWH were more likely to have unsuppressed viral loads, lower CD4 counts, and lower patient reported ART adherence, but these differences were not statistically significant. Perinatally infected PLWH were also more likely to be female and unemployed, and to report consistent condom use. Sexually transmitted diseases were only detected in the behaviorally infected group. Perinatally infected PLWH were also less likely to report alcohol use. However, smoking and illicit drug use were similar between the two groups. There was no difference in racial composition. Asthma and hypertension were the most commonly recorded comorbidities and did not differ in prevalence between the groups (Table 1).The pattern of change in CD4 counts over time was similar between the two groups and both groups maintained average CD4 counts above 200 cells throughout the study (Table 2) (Figure 1). The number and percent of missed appointments were similar between the groups. Patient Characteristics Compared by Perinatally Infected vs. Behaviorally Infected HIV Status A Comparison of Outcomes Over Time Between Perinatally Infected PLWH vs. Behaviorally Infected PLWH Observed Changes in CD4 Count Over Time, Compared by Mode (Perinatally Infected PLWH vs. Behaviorally Infected PLWH) Conclusion Despite differences in reported ART adherence, perinatally and behaviorally infected PLWH had similar rates of HIV viral load suppression and comparable absolute values and trends in CD4 count. Disclosures All Authors: No reported disclosures