@article {3886,
	title = {Relationship Between Alcohol Use Categories and Noninvasive Markers of Advanced Hepatic Fibrosis in HIV-Infected, Chronic Hepatitis C Virus-Infected, and Uninfected Patients.},
	journal = {Clinical infectious diseases : an official publication of the Infectious Diseases Society of America},
	year = {2014},
	month = {2014 Feb 25},
	abstract = {Background.  It is unclear if the risk of liver disease associated with different levels of alcohol consumption is higher for patients infected with human immunodeficiency virus (HIV) or chronic hepatitis C virus (HCV). We evaluated associations between alcohol use categories and advanced hepatic fibrosis, by HIV and chronic HCV status. Methods.  We performed a cross-sectional study among participants in the Veterans Aging Cohort Study who reported alcohol consumption at enrollment (701 HIV/HCV-coinfected; 1,410 HIV-monoinfected; 296 HCV-monoinfected; 1,158 HIV/HCV-uninfected). Alcohol use category was determined by the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) questionnaire and alcohol-related diagnoses and was classified as non-hazardous drinking, hazardous/binge drinking, or alcohol-related diagnosis. Advanced hepatic fibrosis was defined by FIB-4 index >3.25. Results.  Within each HIV/HCV group, the prevalence of advanced hepatic fibrosis increased as alcohol use category increased. For each alcohol use category, advanced hepatic fibrosis was more common among HIV-infected than uninfected (non-hazardous: 6.7\% versus 1.4\%; hazardous/binge: 9.5\% versus 3.0\%; alcohol-related diagnosis: 19.0\% versus 8.6\%; p<0.01) and chronic HCV-infected than uninfected (non-hazardous: 13.6\% versus 2.5\%; hazardous/binge: 18.2\% versus 3.1\%; alcohol-related diagnosis: 22.1\% versus 6.5\%; p<0.01) participants. Strong associations with advanced hepatic fibrosis (adjusted odds ratio [95\% confidence interval]) were observed among HIV/HCV-coinfected patients with non-hazardous drinking (14.2 [5.91-34.0]), hazardous/binge drinking (18.9 [7.98-44.8]), and alcohol-related diagnoses (25.2 [10.6-59.7]) compared to uninfected non-hazardous drinkers. Conclusion.  Advanced hepatic fibrosis was present at low levels of alcohol consumption, increased with higher alcohol use categories, and was more prevalent among HIV-infected and chronic HCV-infected patients than uninfected individuals. All alcohol use categories were strongly associated with advanced hepatic fibrosis in HIV/HCV-coinfected patients.},
	issn = {1537-6591},
	author = {Lim, Joseph K and Tate, Janet P and Fultz, Shawn L and Goulet, Joseph L and Conigliaro, Joseph and Bryant, Kendall J and Gordon, Adam J and Gibert, Cynthia and Rimland, David and Goetz, Matthew Bidwell and Klein, Marina B and Fiellin, David A and Justice, Amy C and Lo Re, Vincent}
}
