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. 2017 Jul;21(7):1878-1884.
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  1 , Heidi M Crane  2 , Carla V Rodriguez  2 , Stephen Van Rompaey  2 , Kenneth H Mayer  3 , Katerina Christopoulos  4 , Sonia Napravnik  5 , Geetanjali Chander  6 , Heidi Hutton  7 , Mary E McCaul  7 , Edward R Cachay  8 , Michael J Mugavero  9 , Richard Moore  6 , Elvin Geng  4 , Joseph J Eron  5 , Michael S Saag  9 , Joseph O Merrill  2 , Mari M Kitahata  10
Affiliations

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

H Nina Kim et al. AIDS Behav. 2017 Jul.

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.

Keywords: Alcohol; CNICS; HIV; Liver fibrosis.

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