The Role of Current and Historical Alcohol Use in Hepatic Fibrosis Among HIV-Infected Individuals

H. Nina Kim; Heidi M. Crane; Carla V. Rodriguez; Stephen Van Rompaey; Kenneth H. Mayer; Katerina Christopoulos; Sonia Napravnik; Geetanjali Chander; Heidi Hutton; Mary E. McCaul; Edward R. Cachay; Michael J. Mugavero; Richard Moore; Elvin Geng; Joseph J. Eron; Michael S. Saag; Joseph O. Merrill; Mari M. Kitahata

doi:10.1007/s10461-016-1665-6

The Role of Current and Historical Alcohol Use in Hepatic Fibrosis Among HIV-Infected Individuals

H. Nina Kim, Heidi M. Crane, Carla V. Rodriguez, Stephen Van Rompaey, Kenneth H. Mayer, Katerina Christopoulos, Sonia Napravnik, Geetanjali Chander, Heidi Hutton, Mary E. McCaul, Edward R. Cachay, Michael J. Mugavero, Richard Moore, Elvin Geng, Joseph J. Eron, Michael S. Saag, Joseph O. Merrill, Mari M. Kitahata

School of Medicine

Research output: Contribution to journal › Article › peer-review

6 Scopus citations

Abstract

We examined risk factors for advanced hepatic fibrosis [fibrosis-4 (FIB)-4 >3.25] including both current alcohol use and a diagnosis of alcohol use disorder among HIV-infected patients. Of the 12,849 patients in our study, 2133 (17%) reported current hazardous drinking by AUDIT-C, 2321 (18%) had a diagnosis of alcohol use disorder, 2376 (18%) were co-infected with chronic hepatitis C virus (HCV); 596 (5%) had high FIB-4 scores >3.25 as did 364 (15%) of HIV/HCV coinfected patients. In multivariable analysis, HCV (adjusted odds ratio (aOR) 6.3, 95% confidence interval (CI) 5.2–7.5), chronic hepatitis B (aOR 2.0, 95% CI 1.5–2.8), diabetes (aOR 2.3, 95% CI 1.8–2.9), current CD4 <200 cells/mm³ (aOR 5.4, 95% CI 4.2–6.9) and HIV RNA >500 copies/mL (aOR 1.3, 95% CI 1.0–1.6) were significantly associated with advanced fibrosis. A diagnosis of an alcohol use disorder (aOR 1.9, 95% CI 1.6–2.3) rather than report of current hazardous alcohol use was associated with high FIB-4. However, among HIV/HCV coinfected patients, both current hazardous drinkers (aOR 1.6, 95% CI 1.1–2.4) and current non-drinkers (aOR 1.6, 95% CI 1.2–2.0) were more likely than non-hazardous drinkers to have high FIB-4, with the latter potentially reflecting the impact of sick abstainers. These findings highlight the importance of using a longitudinal measure of alcohol exposure when evaluating the impact of alcohol on liver disease and associated outcomes.

Original language	English (US)
Pages (from-to)	1878-1884
Number of pages	7
Journal	AIDS and behavior
Volume	21
Issue number	7
DOIs	https://doi.org/10.1007/s10461-016-1665-6
State	Published - Jul 1 2017

Keywords

Alcohol
CNICS
HIV
Liver fibrosis

ASJC Scopus subject areas

Social Psychology
Public Health, Environmental and Occupational Health
Infectious Diseases

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10.1007/s10461-016-1665-6

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Kim, H. N., Crane, H. M., Rodriguez, C. V., Van Rompaey, S., Mayer, K. H., Christopoulos, K., Napravnik, S., Chander, G., Hutton, H., McCaul, M. E., Cachay, E. R., Mugavero, M. J., Moore, R., Geng, E., Eron, J. J., Saag, M. S., Merrill, J. O., & Kitahata, M. M. (2017). The Role of Current and Historical Alcohol Use in Hepatic Fibrosis Among HIV-Infected Individuals. AIDS and behavior, 21(7), 1878-1884. https://doi.org/10.1007/s10461-016-1665-6

Kim, HN, Crane, HM, Rodriguez, CV, Van Rompaey, S, Mayer, KH, Christopoulos, K, Napravnik, S, Chander, G, Hutton, H, McCaul, ME, Cachay, ER, Mugavero, MJ, Moore, R, Geng, E, Eron, JJ, Saag, MS, Merrill, JO & Kitahata, MM 2017, 'The Role of Current and Historical Alcohol Use in Hepatic Fibrosis Among HIV-Infected Individuals', AIDS and behavior, vol. 21, no. 7, pp. 1878-1884. https://doi.org/10.1007/s10461-016-1665-6

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abstract = "We examined risk factors for advanced hepatic fibrosis [fibrosis-4 (FIB)-4 >3.25] including both current alcohol use and a diagnosis of alcohol use disorder among HIV-infected patients. Of the 12,849 patients in our study, 2133 (17%) reported current hazardous drinking by AUDIT-C, 2321 (18%) had a diagnosis of alcohol use disorder, 2376 (18%) were co-infected with chronic hepatitis C virus (HCV); 596 (5%) had high FIB-4 scores >3.25 as did 364 (15%) of HIV/HCV coinfected patients. In multivariable analysis, HCV (adjusted odds ratio (aOR) 6.3, 95% confidence interval (CI) 5.2–7.5), chronic hepatitis B (aOR 2.0, 95% CI 1.5–2.8), diabetes (aOR 2.3, 95% CI 1.8–2.9), current CD4 <200 cells/mm3 (aOR 5.4, 95% CI 4.2–6.9) and HIV RNA >500 copies/mL (aOR 1.3, 95% CI 1.0–1.6) were significantly associated with advanced fibrosis. A diagnosis of an alcohol use disorder (aOR 1.9, 95% CI 1.6–2.3) rather than report of current hazardous alcohol use was associated with high FIB-4. However, among HIV/HCV coinfected patients, both current hazardous drinkers (aOR 1.6, 95% CI 1.1–2.4) and current non-drinkers (aOR 1.6, 95% CI 1.2–2.0) were more likely than non-hazardous drinkers to have high FIB-4, with the latter potentially reflecting the impact of sick abstainers. These findings highlight the importance of using a longitudinal measure of alcohol exposure when evaluating the impact of alcohol on liver disease and associated outcomes.",

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author = "Kim, {H. Nina} and Crane, {Heidi M.} and Rodriguez, {Carla V.} and {Van Rompaey}, Stephen and Mayer, {Kenneth H.} and Katerina Christopoulos and Sonia Napravnik and Geetanjali Chander and Heidi Hutton and McCaul, {Mary E.} and Cachay, {Edward R.} and Mugavero, {Michael J.} and Richard Moore and Elvin Geng and Eron, {Joseph J.} and Saag, {Michael S.} and Merrill, {Joseph O.} and Kitahata, {Mari M.}",

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AU - Crane, Heidi M.

AU - Rodriguez, Carla V.

AU - Van Rompaey, Stephen

AU - Mayer, Kenneth H.

AU - Christopoulos, Katerina

AU - Napravnik, Sonia

AU - Chander, Geetanjali

AU - Hutton, Heidi

AU - McCaul, Mary E.

AU - Cachay, Edward R.

AU - Mugavero, Michael J.

AU - Moore, Richard

AU - Geng, Elvin

AU - Eron, Joseph J.

AU - Saag, Michael S.

AU - Merrill, Joseph O.

AU - Kitahata, Mari M.

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N2 - We examined risk factors for advanced hepatic fibrosis [fibrosis-4 (FIB)-4 >3.25] including both current alcohol use and a diagnosis of alcohol use disorder among HIV-infected patients. Of the 12,849 patients in our study, 2133 (17%) reported current hazardous drinking by AUDIT-C, 2321 (18%) had a diagnosis of alcohol use disorder, 2376 (18%) were co-infected with chronic hepatitis C virus (HCV); 596 (5%) had high FIB-4 scores >3.25 as did 364 (15%) of HIV/HCV coinfected patients. In multivariable analysis, HCV (adjusted odds ratio (aOR) 6.3, 95% confidence interval (CI) 5.2–7.5), chronic hepatitis B (aOR 2.0, 95% CI 1.5–2.8), diabetes (aOR 2.3, 95% CI 1.8–2.9), current CD4 <200 cells/mm3 (aOR 5.4, 95% CI 4.2–6.9) and HIV RNA >500 copies/mL (aOR 1.3, 95% CI 1.0–1.6) were significantly associated with advanced fibrosis. A diagnosis of an alcohol use disorder (aOR 1.9, 95% CI 1.6–2.3) rather than report of current hazardous alcohol use was associated with high FIB-4. However, among HIV/HCV coinfected patients, both current hazardous drinkers (aOR 1.6, 95% CI 1.1–2.4) and current non-drinkers (aOR 1.6, 95% CI 1.2–2.0) were more likely than non-hazardous drinkers to have high FIB-4, with the latter potentially reflecting the impact of sick abstainers. These findings highlight the importance of using a longitudinal measure of alcohol exposure when evaluating the impact of alcohol on liver disease and associated outcomes.

AB - We examined risk factors for advanced hepatic fibrosis [fibrosis-4 (FIB)-4 >3.25] including both current alcohol use and a diagnosis of alcohol use disorder among HIV-infected patients. Of the 12,849 patients in our study, 2133 (17%) reported current hazardous drinking by AUDIT-C, 2321 (18%) had a diagnosis of alcohol use disorder, 2376 (18%) were co-infected with chronic hepatitis C virus (HCV); 596 (5%) had high FIB-4 scores >3.25 as did 364 (15%) of HIV/HCV coinfected patients. In multivariable analysis, HCV (adjusted odds ratio (aOR) 6.3, 95% confidence interval (CI) 5.2–7.5), chronic hepatitis B (aOR 2.0, 95% CI 1.5–2.8), diabetes (aOR 2.3, 95% CI 1.8–2.9), current CD4 <200 cells/mm3 (aOR 5.4, 95% CI 4.2–6.9) and HIV RNA >500 copies/mL (aOR 1.3, 95% CI 1.0–1.6) were significantly associated with advanced fibrosis. A diagnosis of an alcohol use disorder (aOR 1.9, 95% CI 1.6–2.3) rather than report of current hazardous alcohol use was associated with high FIB-4. However, among HIV/HCV coinfected patients, both current hazardous drinkers (aOR 1.6, 95% CI 1.1–2.4) and current non-drinkers (aOR 1.6, 95% CI 1.2–2.0) were more likely than non-hazardous drinkers to have high FIB-4, with the latter potentially reflecting the impact of sick abstainers. These findings highlight the importance of using a longitudinal measure of alcohol exposure when evaluating the impact of alcohol on liver disease and associated outcomes.

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The Role of Current and Historical Alcohol Use in Hepatic Fibrosis Among HIV-Infected Individuals

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Keywords

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