TY - JOUR
T1 - The Role of Current and Historical Alcohol Use in Hepatic Fibrosis Among HIV-Infected Individuals
AU - Kim, H. Nina
AU - Crane, Heidi M.
AU - Rodriguez, Carla V.
AU - Van Rompaey, Stephen
AU - Mayer, Kenneth H.
AU - Christopoulos, Katerina
AU - Napravnik, Sonia
AU - Chander, Geetanjali
AU - Hutton, Heidi
AU - McCaul, Mary E.
AU - Cachay, Edward R.
AU - Mugavero, Michael J.
AU - Moore, Richard
AU - Geng, Elvin
AU - Eron, Joseph J.
AU - Saag, Michael S.
AU - Merrill, Joseph O.
AU - Kitahata, Mari M.
N1 - Publisher Copyright:
© 2016, Springer Science+Business Media New York.
PY - 2017/7/1
Y1 - 2017/7/1
N2 - We examined risk factors for advanced hepatic fibrosis [fibrosis-4 (FIB)-4 >3.25] including both current alcohol use and a diagnosis of alcohol use disorder among HIV-infected patients. Of the 12,849 patients in our study, 2133 (17%) reported current hazardous drinking by AUDIT-C, 2321 (18%) had a diagnosis of alcohol use disorder, 2376 (18%) were co-infected with chronic hepatitis C virus (HCV); 596 (5%) had high FIB-4 scores >3.25 as did 364 (15%) of HIV/HCV coinfected patients. In multivariable analysis, HCV (adjusted odds ratio (aOR) 6.3, 95% confidence interval (CI) 5.2–7.5), chronic hepatitis B (aOR 2.0, 95% CI 1.5–2.8), diabetes (aOR 2.3, 95% CI 1.8–2.9), current CD4 <200 cells/mm3 (aOR 5.4, 95% CI 4.2–6.9) and HIV RNA >500 copies/mL (aOR 1.3, 95% CI 1.0–1.6) were significantly associated with advanced fibrosis. A diagnosis of an alcohol use disorder (aOR 1.9, 95% CI 1.6–2.3) rather than report of current hazardous alcohol use was associated with high FIB-4. However, among HIV/HCV coinfected patients, both current hazardous drinkers (aOR 1.6, 95% CI 1.1–2.4) and current non-drinkers (aOR 1.6, 95% CI 1.2–2.0) were more likely than non-hazardous drinkers to have high FIB-4, with the latter potentially reflecting the impact of sick abstainers. These findings highlight the importance of using a longitudinal measure of alcohol exposure when evaluating the impact of alcohol on liver disease and associated outcomes.
AB - We examined risk factors for advanced hepatic fibrosis [fibrosis-4 (FIB)-4 >3.25] including both current alcohol use and a diagnosis of alcohol use disorder among HIV-infected patients. Of the 12,849 patients in our study, 2133 (17%) reported current hazardous drinking by AUDIT-C, 2321 (18%) had a diagnosis of alcohol use disorder, 2376 (18%) were co-infected with chronic hepatitis C virus (HCV); 596 (5%) had high FIB-4 scores >3.25 as did 364 (15%) of HIV/HCV coinfected patients. In multivariable analysis, HCV (adjusted odds ratio (aOR) 6.3, 95% confidence interval (CI) 5.2–7.5), chronic hepatitis B (aOR 2.0, 95% CI 1.5–2.8), diabetes (aOR 2.3, 95% CI 1.8–2.9), current CD4 <200 cells/mm3 (aOR 5.4, 95% CI 4.2–6.9) and HIV RNA >500 copies/mL (aOR 1.3, 95% CI 1.0–1.6) were significantly associated with advanced fibrosis. A diagnosis of an alcohol use disorder (aOR 1.9, 95% CI 1.6–2.3) rather than report of current hazardous alcohol use was associated with high FIB-4. However, among HIV/HCV coinfected patients, both current hazardous drinkers (aOR 1.6, 95% CI 1.1–2.4) and current non-drinkers (aOR 1.6, 95% CI 1.2–2.0) were more likely than non-hazardous drinkers to have high FIB-4, with the latter potentially reflecting the impact of sick abstainers. These findings highlight the importance of using a longitudinal measure of alcohol exposure when evaluating the impact of alcohol on liver disease and associated outcomes.
KW - Alcohol
KW - CNICS
KW - HIV
KW - Liver fibrosis
UR - https://www.scopus.com/pages/publications/85007482693
U2 - 10.1007/s10461-016-1665-6
DO - 10.1007/s10461-016-1665-6
M3 - Article
C2 - 28035496
AN - SCOPUS:85007482693
SN - 1090-7165
VL - 21
SP - 1878
EP - 1884
JO - AIDS and Behavior
JF - AIDS and Behavior
IS - 7
ER -