874. Impact of Telehealth in HIV Ambulatory Clinic during COVID-19 Pandemic Impact of Telehealth in HIV Ambulatory Clinic during COVID-19 Pandemic

Background HIV outpatient in-person (IN-P) visits were limited during the COVID-19 pandemic, and most patients (pts) were cared for remotely through telehealth (TELE). We sought to evaluate the impact of TELE on HIV infected pts during the pandemic compared to the pre-pandemic IN-P care. Methods Retrospective chart review of pts in an outpatient HIV clinic, study period 03/30/2019 to 03/29/2021. Two periods were defined: pre-COVID (Pre-CO) 3/30/2019 to 3/29/2020 and COVID (CO) 3/30/2020 to 3/29/2021. Data was collected on demographics, HIV risk, type of encounter, number of encounters, CD4, HIV Viral loads (VL) at first, and last visit, treatment regimen information. HIV VL < 200 copies/ml was considered as undetectable. Results A total of 607 pts were evaluated. Mean age 51years; (Range-20-84). Male 306 (50.4%), African American 545(90%), Hispanic 50 (8.2%), white 9 (1.5%), Asian 3(0.5%). HIV risk: heterosexual 437(72%), male sex with male 118(19.4%), intravenous drug use 8 (1.3%). In the Pre-CO period, 530 pts were seen as IN-P; in the CO period 606 pts were encountered of which 304 (50.2%) were TELE visits, 89(14.7%) IN-P, 213(35%) had both TELE and IN-P encounters. Mean number of encounters were 2.59 in the Pre-CO and 2.46 during CO. The number of new pts in the Pre-CO were 36 (7%) vs. 52(8.6%) in the CO (p=0.26). During the pre-CO, 373 pts had CD4 measured at first and last visits, 353(95%) at the first visit and 352 (94.3%) at the last visit had CD4 counts ≥ 200/uL (p=.87); 373 pts had a VL done at first and last visits, 330 (88.5%) at the first visit and 337(90.3%) at last visit were undetectable (p=0.41). During CO, 445 pts had CD4 measured at first and last visits, 402 (90.3%) at the first visit and 445(94.2%) at the last visit had CD4 count ≥200/uL (p=0.03); 448 pts had VL measured at first and last encounters, 389(87%) at the first visit and 417(93%) in the last visit were undetectable (p=0.002). Antiretroviral changes occurred in 29% in the Pre-Co compared to 19% in the CO (p=0 .32). Conclusion In our clinic, more pts were cared for during the CO period compared to the Pre-CO period. Significantly, more pts had undetectable HIV VL during CO period. At least one TELE visit was utilized by over ¾ of the pts. TELE has a potentially important role in future HIV care without compromising patient outcomes. Disclosures All Authors: No reported disclosures

Relationship between Persistent Dizziness and Markers of Alzheimer's disease – Mayo Clinic Study of Aging

Persistent dizziness or lightheadedness ranks among the most frequent complaints in primary care. Persistent dizziness is frequently described as a consequence or side effect of defined entities such as cardiovascular, infectious, neurological, and otological disease. Persistent dizziness is potentially disabling and has a distinct impact on participation, psychosocial interaction, and quality of life. We examined the relationship between persistent dizziness or lightheadedness and Alzheimer's disease (AD) markers among 924 individuals aged ≥50 years (52.3% male, mean age 74 years) selected from 5707 individuals who participated in the population-based Mayo Clinic Study of Aging in Olmsted County, Minnesota. Neuropsychiatric symptoms (depression and anxiety), cognitive evaluation (overall and across multiple domains), magnetic resonance imaging for AD-signature "regional thickness," and 11Carbon-Pittsburgh compound B positron emission tomography (11C-PiB PET) for Amyloid deposition are all investigated. Significant contributing factors to persistent dizziness in older adults were found and include [age, sex (male), lower education, high comorbidity index, high-density lipoprotein, balance problems, neuropsychiatric symptoms, cognitive impairments, and AD-signature” regional thickness]. After adjusting for age, sex, education, medical comorbidities, and other variables, a statistically significant association between persistent dizziness/lightheadedness and neuropsychiatric symptoms, and Amyloid-β deposition. This finding implies that the underlying AD biology may drive both the neuropsychiatric symptoms and persistent dizziness or lightheadedness, even before the onset of cognitive impairments and dementia. Further studies are needed to support the findings.