Moderate Alcohol Use Is Not Associated with Fibrosis Progression in Human Immunodeficiency Virus/Hepatitis C Virus-Coinfected Women: A Prospective Cohort Study

Erin M. Kelly, Jennifer L. Dodge, Peter Bacchetti, Monika Sarkar, Audrey L. French, Phyllis C. Tien, Marshall J. Glesby, Elizabeth Golub, Michael Augenbraun, Michael Plankey, Marion G. Peters

Research output: Contribution to journalArticle

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 languageEnglish (US)
Pages (from-to)2050-2056
Number of pages7
JournalClinical Infectious Diseases
Volume65
Issue number12
DOIs
StatePublished - Dec 15 2017

Fingerprint

Hepacivirus
Fibrosis
Cohort Studies
Alcohols
HIV
Prospective Studies
Confidence Intervals
Drinking
Light
Liver Cirrhosis
Chronic Hepatitis C
Virus Diseases
Alcohol Drinking
Liver

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 journalArticle

Kelly, EM, Dodge, JL, Bacchetti, P, Sarkar, M, French, AL, Tien, PC, Glesby, MJ, Golub, E, Augenbraun, M, Plankey, M & Peters, MG 2017, 'Moderate Alcohol Use Is Not Associated with Fibrosis Progression in Human Immunodeficiency Virus/Hepatitis C Virus-Coinfected Women: A Prospective Cohort Study', Clinical Infectious Diseases, vol. 65, no. 12, pp. 2050-2056. https://doi.org/10.1093/cid/cix716
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. / Moderate Alcohol Use Is Not Associated with Fibrosis Progression in Human Immunodeficiency Virus/Hepatitis C Virus-Coinfected Women : A Prospective Cohort Study. In: Clinical Infectious Diseases. 2017 ; Vol. 65, No. 12. pp. 2050-2056.
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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.",
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author = "Kelly, {Erin M.} and Dodge, {Jennifer L.} and Peter Bacchetti and Monika Sarkar and French, {Audrey L.} and Tien, {Phyllis C.} and Glesby, {Marshall J.} and Elizabeth Golub and Michael Augenbraun and Michael Plankey and Peters, {Marion G.}",
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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

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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.

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