Poster Abstracts • OFID 2019:6 (Suppl 2) • S193 368. Incidental Findings on Brain MRI in People Living with HIV Kevin F. Hanna, BS; Harlan R. Sayles, MS; Jennifer O’Neil, RN, BSN; Matthew White, MD; Tony Wilson, PhD and Susan Swindells, MBBS; University of Nebraska Medical Center, Bellevue, Nebraska Session: 46. HIV Complications: Neurologic Complications Thursday, October 3, 2019: 12:15 PM Background. HIV infection is associated with an array of neurocognitive changes, collectively referred to as HIV-Associated Neurocognitive Disorder (HAND). Tese changes have been the subject of a great deal of study, ofen including structural MRI of the brain. Incidental fndings (IF) are a well-known complication of imaging studies done for both diagnostic and research indications, and can pose important ethical and clinical dilemmas. Little is known about the rates and types of IF found on brain MRI in patients with HIV infection. We identifed and characterized such fndings in partici- pants who participated in a study of neurophysiological markers of HAND. Methods. Te parent study included 108 HIV-infected adults and 125 demograph- ically matched uninfected controls without cognitive impairment who had undergone T1-weighted structural brain MRI for research purposes. Demographic and diagnostic data were abstracted from the research records. Each MRI study was read by the same neuro- radiologist, blind to the participant’s HIV status. IF were classifed as vascular, neoplastic, congenital, other neurologic, or non-neurologic. Categorical measures were compared using Pearson chi-square tests while continuous measures were compared using t-tests. Results. Among HIV-infected participants, 36/108 (33.3%) had IF compared with 33/125 (26.4%) of controls (P = 0.248). Rates of IF were signifcantly correlated with increased age in both HIV-infected and control participants. We found no cor- relation among presence or absence of IF and sex, race/ethnicity, or CD4 count and HAND status for the HIV-infected cohort. Te most common categories were neuro- logic (27), followed by non-neurologic (8), vascular (6), and neoplastic (2) (Table 1). Conclusion. If were common in both HIV-infected participants and controls, at higher rates than previously reported, possibly because of increased sensitivity of MRI machines over time. Surprisingly, we found no signifcant diference between the groups and no correlation with HAND status or CD4 count. Age was the only factor correlated with rates of IF in either HIV-infected participants or controls. To our knowledge, this study is the frst of its kind to characterize incidental fndings in HIV-infected patients. Disclosures. All authors: No reported disclosures. 369. Association Between Depression and HIV Treatment Outcomes in a US Military Population with HIV Infection Brandon Carney, MD 1 ; Colton Daniels, MS 2 ; Xiaohe Xu, PhD 2 ; Tankam Sunil, PhD 2 ; Anuradha Ganesan, MBBS, MPH 3 ; Jason M. Blaylock, MD 4 ; Karl Kronmann, MD 5 ; Christina Schofeld, MD 6 ; Lalani Tahaniyat, PhD 7 ; Brian Agan, MD 8 and Jason Okulicz, MD 9 ; 1 SAUSHEC (San Antonio Military Medical Center), San Antonio, Texas; 2 University of Texas at San Antonio, San Antonio, Texas; 3 Infectious Disease Clinical Research Program and the Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD and Walter Reed National Military Medical Center, Bethesda, Maryland, ; 4 Walter Reed National Military Medical Center, Bethesda, Maryland; 5 Naval Medical Center, Portsmouth, Virginia; 6 Madigan Army Medical Center, Tacoma, Washington; 7 IDCRP, HJF, and NMCP, Bethesda, Maryland; 8 Infectious Disease Clinical Research Program of the Uniformed Services University of the Health Sciences and the Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, North Bethesda, Maryland; 9 Brooke Army Medical Center, JBSA Fort Sam Houston, , San Antonio, Texas Session: 46. HIV Complications: Neurologic Complications Thursday, October 3, 2019: 12:15 PM Background. Depression is common among HIV-infected individuals and may con- tribute to suboptimal adherence to antiretroviral therapy (ART) and reduced rates of viral load (VL) suppression. We evaluated longitudinal HIV treatment outcomes in US Military HIV Natural History Study (NHS) participants with or without a diagnosis depression. Methods. Male NHS participants with available ICD-9 data for mental health diagnoses and self-reported adherence (SRA) were included (n = 549). Groups were defned as having a history of depression (n = 188, 34.2%), classifed as major depres- sive disorder and/or anxiety disorder, or no history of depression (n = 361, 65.8%). Delay in ART initiation was defned as the time from HIV diagnosis to ART start greater than the group mean (4.91 ± 4.69 years). SRA was defned as taking ≥95% of ART doses and continuous ART was defned as longitudinal ART use with gaps < 30 days. Continuous VL suppression was defned as maintaining VLs < 200 c/mL on ART. Logistic regression analysis was performed comparing variables for those with and without a coded diagnosis of depression. Results. Participants had a mean age of 33 (±8.36) years at HIV diagnosis, and similar proportions were Caucasian (44.3%) or African American (40.8%). At ART initiation, the mean CD4 count was 370 (±154 cells/μL) and 362 (±163 cells/μL) for those with and without a history of depression, respectively. Overall, older participants at HIV diagnosis had greater odds of having high SRA (OR 1.07, 95% CI 1.03–1.11), and compared with Caucasians, African Americans had lower odds of having high SRA (OR 0.43, 95% CI 0.25–0.75; table). Participants with a history of depression had greater odds of experiencing delayed ART initiation (OR 2.12, 95% CI 1.11–4.05). However, they also had greater odds of remaining on continuous ART (OR 1.38, 95% CI 0.95–2.02) during follow-up compared with those without a history of depression. Conclusion. Although HIV-infected individuals with depression were more likely to experience delays in ART initiation, there were no observed diferences in SRA or VL suppression. Continued eforts to identify and aggressively manage mental health disorders are important to success along the HIV care continuum. Disclosures. All authors: No reported disclosures. Downloaded from https://academic.oup.com/ofid/article/6/Supplement_2/S193/5604703 by guest on 28 October 2022