Abstract
Background. Heavy alcohol use can lead to progressive liver damage, especially in individuals with chronic hepatitis C (HCV); however, the impact of nonheavy use is not clear. We studied long-term effects of modest alcohol use on fibrosis progression in a large cohort of women coinfected with human immunodeficiency virus (HIV)/HCV. Methods. Alcohol intake was ascertained every 6 months and use categorized as abstinent, light (1-3 drinks/week), moderate (4-7 drinks/week), heavy (>7 drinks/week), and very heavy (>14 drinks/week). Fibrosis progression was defined as the change in Fibrosis-4 Index for Liver Fibrosis (FIB-4) units per year using random-intercept, random-slope mixed modeling. Results. Among 686 HIV/HCV-coinfected women, 46.0% reported no alcohol use; 26.8% reported light use, 7.1% moderate use, and 19.7% heavy use (6.7% had 8-14 drinks/week and 13.0% had >14 drinks/week) at cohort entry. Median FIB-4 at entry was similar between groups. On multivariable analysis, compared to abstainers, light and moderate alcohol use was not associated with fibrosis progression (0.004 [95% confidence interval {CI},-.11 to .12] and 0.006 [95% CI,-.18 to .19] FIB-4 units/year, respectively). Very heavy drinking (>14 drinks/week) showed significant fibrosis acceleration (0.25 [95% CI, .01-.49] FIB-4 units/year) compared to abstaining, whereas drinking 8-14 drinks per week showed minimal acceleration of fibrosis progression (0.04 [95% CI,-.19 to .28] FIB-4 units/year). Conclusions. Light/moderate alcohol use was not substantially associated with accelerated fibrosis progression, whereas drinking >14 drinks per week showed increased rates of fibrosis progression. Women with HIV/HCV infection should be counseled against heavy alcohol consumption, but complete abstinence may not be required to prevent accelerated liver fibrosis progression.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 2050-2056 |
| Number of pages | 7 |
| Journal | Clinical Infectious Diseases |
| Volume | 65 |
| Issue number | 12 |
| DOIs | |
| State | Published - Dec 15 2017 |
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Keywords
- alcohol
- coinfection
- FIB-4
- fibrosis
- hepatitis C
ASJC Scopus subject areas
- Microbiology (medical)
- Infectious Diseases
Cite this
Moderate Alcohol Use Is Not Associated with Fibrosis Progression in Human Immunodeficiency Virus/Hepatitis C Virus-Coinfected Women : A Prospective Cohort Study. / Kelly, Erin M.; Dodge, Jennifer L.; Bacchetti, Peter; Sarkar, Monika; French, Audrey L.; Tien, Phyllis C.; Glesby, Marshall J.; Golub, Elizabeth; Augenbraun, Michael; Plankey, Michael; Peters, Marion G.
In: Clinical Infectious Diseases, Vol. 65, No. 12, 15.12.2017, p. 2050-2056.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Moderate Alcohol Use Is Not Associated with Fibrosis Progression in Human Immunodeficiency Virus/Hepatitis C Virus-Coinfected Women
T2 - A Prospective Cohort Study
AU - Kelly, Erin M.
AU - Dodge, Jennifer L.
AU - Bacchetti, Peter
AU - Sarkar, Monika
AU - French, Audrey L.
AU - Tien, Phyllis C.
AU - Glesby, Marshall J.
AU - Golub, Elizabeth
AU - Augenbraun, Michael
AU - Plankey, Michael
AU - Peters, Marion G.
PY - 2017/12/15
Y1 - 2017/12/15
N2 - Background. Heavy alcohol use can lead to progressive liver damage, especially in individuals with chronic hepatitis C (HCV); however, the impact of nonheavy use is not clear. We studied long-term effects of modest alcohol use on fibrosis progression in a large cohort of women coinfected with human immunodeficiency virus (HIV)/HCV. Methods. Alcohol intake was ascertained every 6 months and use categorized as abstinent, light (1-3 drinks/week), moderate (4-7 drinks/week), heavy (>7 drinks/week), and very heavy (>14 drinks/week). Fibrosis progression was defined as the change in Fibrosis-4 Index for Liver Fibrosis (FIB-4) units per year using random-intercept, random-slope mixed modeling. Results. Among 686 HIV/HCV-coinfected women, 46.0% reported no alcohol use; 26.8% reported light use, 7.1% moderate use, and 19.7% heavy use (6.7% had 8-14 drinks/week and 13.0% had >14 drinks/week) at cohort entry. Median FIB-4 at entry was similar between groups. On multivariable analysis, compared to abstainers, light and moderate alcohol use was not associated with fibrosis progression (0.004 [95% confidence interval {CI},-.11 to .12] and 0.006 [95% CI,-.18 to .19] FIB-4 units/year, respectively). Very heavy drinking (>14 drinks/week) showed significant fibrosis acceleration (0.25 [95% CI, .01-.49] FIB-4 units/year) compared to abstaining, whereas drinking 8-14 drinks per week showed minimal acceleration of fibrosis progression (0.04 [95% CI,-.19 to .28] FIB-4 units/year). Conclusions. Light/moderate alcohol use was not substantially associated with accelerated fibrosis progression, whereas drinking >14 drinks per week showed increased rates of fibrosis progression. Women with HIV/HCV infection should be counseled against heavy alcohol consumption, but complete abstinence may not be required to prevent accelerated liver fibrosis progression.
AB - Background. Heavy alcohol use can lead to progressive liver damage, especially in individuals with chronic hepatitis C (HCV); however, the impact of nonheavy use is not clear. We studied long-term effects of modest alcohol use on fibrosis progression in a large cohort of women coinfected with human immunodeficiency virus (HIV)/HCV. Methods. Alcohol intake was ascertained every 6 months and use categorized as abstinent, light (1-3 drinks/week), moderate (4-7 drinks/week), heavy (>7 drinks/week), and very heavy (>14 drinks/week). Fibrosis progression was defined as the change in Fibrosis-4 Index for Liver Fibrosis (FIB-4) units per year using random-intercept, random-slope mixed modeling. Results. Among 686 HIV/HCV-coinfected women, 46.0% reported no alcohol use; 26.8% reported light use, 7.1% moderate use, and 19.7% heavy use (6.7% had 8-14 drinks/week and 13.0% had >14 drinks/week) at cohort entry. Median FIB-4 at entry was similar between groups. On multivariable analysis, compared to abstainers, light and moderate alcohol use was not associated with fibrosis progression (0.004 [95% confidence interval {CI},-.11 to .12] and 0.006 [95% CI,-.18 to .19] FIB-4 units/year, respectively). Very heavy drinking (>14 drinks/week) showed significant fibrosis acceleration (0.25 [95% CI, .01-.49] FIB-4 units/year) compared to abstaining, whereas drinking 8-14 drinks per week showed minimal acceleration of fibrosis progression (0.04 [95% CI,-.19 to .28] FIB-4 units/year). Conclusions. Light/moderate alcohol use was not substantially associated with accelerated fibrosis progression, whereas drinking >14 drinks per week showed increased rates of fibrosis progression. Women with HIV/HCV infection should be counseled against heavy alcohol consumption, but complete abstinence may not be required to prevent accelerated liver fibrosis progression.
KW - alcohol
KW - coinfection
KW - FIB-4
KW - fibrosis
KW - hepatitis C
UR - http://www.scopus.com/inward/record.url?scp=85040070360&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85040070360&partnerID=8YFLogxK
U2 - 10.1093/cid/cix716
DO - 10.1093/cid/cix716
M3 - Article
C2 - 29020382
AN - SCOPUS:85040070360
VL - 65
SP - 2050
EP - 2056
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
SN - 1058-4838
IS - 12
ER -