Yale University

How harmful is hazardous alcohol use and abuse in HIV infection: do health care providers know who is at risk?

TitleHow harmful is hazardous alcohol use and abuse in HIV infection: do health care providers know who is at risk?
Publication TypeJournal Article
Year of Publication2003
AuthorsConigliaro, Joseph, Adam J. Gordon, Kathleen A. McGinnis, Linda Rabeneck, and Amy C. Justice
Corporate AuthorsVeterans Aging Cohort 3-Site Study
JournalJournal of acquired immune deficiency syndromes (1999)
Date Published2003 Aug 1
KeywordsAdult, Aged, Alcohol Drinking, Alcoholism, Cohort Studies, Female, Health Personnel, HIV Infections, Humans, Male, Middle Aged, Prospective Studies, Referral and Consultation, Risk, Veterans
AbstractWe conducted a prospective cohort study to describe the association between alcohol use, HIV disease progression, and drug toxicity and to determine health care provider awareness of excessive alcohol use by recruiting 881 HIV-infected veterans (median age, 49 years; 99% male; 54% African American) from 3 VA HIV clinics. Twenty percent of patients were hazardous drinkers by the Alcohol Use Disorders Identification Test, 33% were binge drinkers, 32% had a chart ICD-9 alcohol diagnosis, and 12.5% and 66.7%, respectively, were described by their health care providers as currently and ever drinking "too much." Hazardous/binge drinkers more often had detectable viral loads (P < 0.001). Patients with alcohol diagnoses more often had elevated alanine transaminase or aspartate transaminase levels (P 200/mL. We conclude that in HIV-positive veterans, hazardous drinking and alcohol diagnoses were common and associated with HIV disease progression and/or hepatic comorbidity and anemia. Health care providers more often missed alcohol problems in patients with less severe HIV infection and those without evidence of liver disease. Health care providers should routinely screen and counsel patients regarding alcohol problems as part of standard of care to minimize disease progression and bone marrow and hepatic toxicity.
Alternate JournalJ. Acquir. Immune Defic. Syndr.

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