| Title | Relationship Between Alcohol Use Categories and Noninvasive Markers of Advanced Hepatic Fibrosis in HIV-Infected, Chronic Hepatitis C Virus-Infected, and Uninfected Patients. |
| Publication Type | Journal Article |
| Year of Publication | 2014 |
| Authors | Lim, Joseph K., Janet P. Tate, Shawn L. Fultz, Joseph L. Goulet, Joseph Conigliaro, Kendall J. Bryant, Adam J. Gordon, Cynthia Gibert, David Rimland, Matthew Bidwell Goetz, Marina B. Klein, David A. Fiellin, Amy C. Justice, and Vincent Lo Re |
| Journal | Clinical infectious diseases : an official publication of the Infectious Diseases Society of America |
| Date Published | 2014 Feb 25 |
| ISSN | 1537-6591 |
| 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. |
| Alternate Journal | Clin. Infect. Dis. |
