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AIDS Behav. 2017 Jul;21(7):1878-1884. doi: 10.1007/s10461-016-1665-6.

The Role of Current and Historical Alcohol Use in Hepatic Fibrosis Among HIV-Infected Individuals.

Author information

1
Division of Allergy and Infectious Diseases, Department of Medicine, School of Medicine, University of Washington, 325 Ninth Avenue, Box 359930, Seattle, WA, 98104, USA. hyangkim@uw.edu.
2
Division of Allergy and Infectious Diseases, Department of Medicine, School of Medicine, University of Washington, 325 Ninth Avenue, Box 359930, Seattle, WA, 98104, USA.
3
Fenway Institute, Fenway Health, Boston, MA, USA.
4
School of Medicine, University of California San Francisco, San Francisco, CA, USA.
5
Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
6
Department of Medicine, Johns Hopkins University, Baltimore, MD, USA.
7
Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
8
Department of Medicine, University of California San Diego, San Diego, CA, USA.
9
Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, AB, USA.
10
Division of Allergy and Infectious Diseases, Department of Medicine, School of Medicine, University of Washington, 325 Ninth Avenue, Box 359930, Seattle, WA, 98104, USA. kitahata@uw.edu.

Abstract

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.

KEYWORDS:

Alcohol; CNICS; HIV; Liver fibrosis

PMID:
28035496
PMCID:
PMC6029880
DOI:
10.1007/s10461-016-1665-6
[Indexed for MEDLINE]
Free PMC Article

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