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Interaction Between Alcohol Consumption Patterns, Antiretroviral Therapy Type, and Liver Fibrosis in Persons Living with HIV
Journal article   Open access   Peer reviewed

Interaction Between Alcohol Consumption Patterns, Antiretroviral Therapy Type, and Liver Fibrosis in Persons Living with HIV

Usama Bilal, Bryan Lau, Mariana Lazo, Mary E McCaul, Heidi E Hutton, Mark S Sulkowski, Richard D Moore and Geetanjali Chander
AIDS patient care and STDs, v 30(5)
May 2016
DOI: https://doi.org/10.1089/apc.2016.0010
PMID: 27158847
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1089/apc.2016.0010View
Published, Version of Record (VoR)Open Access (License Unspecified),  Open

Abstract

Adult Alcohol Drinking - adverse effects Alcohol Drinking - epidemiology Alcohol Drinking - pathology Alcoholism - diagnosis Alcoholism - epidemiology Antiretroviral Therapy, Highly Active - methods Cohort Studies Coinfection - diagnosis Coinfection - epidemiology Female Hepacivirus Hepatitis C - diagnosis Hepatitis C - epidemiology Hepatitis C, Chronic - complications HIV Infections - complications HIV Infections - drug therapy Humans Liver Cirrhosis - complications Liver Cirrhosis - epidemiology Liver Cirrhosis - virology Liver Cirrhosis, Alcoholic - complications Longitudinal Studies Male Middle Aged Population Surveillance - methods Prospective Studies Viral Load
We examined the longitudinal association between alcohol use and liver fibrosis, measured by FIB-4 Score, among HIV-infected individuals by (1) antiretroviral therapy (ART) class, and (2) the presence of hepatitis C (HCV) co-infection. This was a prospective cohort study of 550 individuals in the Johns Hopkins HIV Clinical Cohort initiating ART between 2000 and 2012. The relationship between alcohol consumption (defined using NIAAA categories of non-, moderate, and hazardous drinkers) and liver fibrosis (FIB-4 score) by ART class was assessed using linear mixed effects models. Additionally, we examined whether the presence of HCV modified and whether viral load mediated the relationship between alcohol use and liver fibrosis. Overall, FIB-4 levels were 15.6% higher in hazardous drinkers compared to moderate drinkers (p = 0.025) after adjusting by age, sex, and race. Hazardous drinkers on PI-based regimens had FIB-4 scores 26.9% higher than moderate drinkers (p = 0.015). However, there was no difference in FIB-4 levels between hazardous drinkers on non-PI-based regimens compared to moderate drinkers (1.83% versus moderate drinkers, p = 0.848). There was no significant difference in FIB-4 between nondrinkers and moderate drinkers, irrespective of ART regimen. These associations were not modified by HCV status or mediated by viral load changes. Individuals with hazardous alcohol consumption and on PI-based regimens had significantly increased liver fibrosis, as measured by the FIB-4. These data suggest that providers should consider level of alcohol consumption when choosing an ART regimen to minimize detrimental effects on the liver.

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30 citations in Web of Science
30 citations in Scopus

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

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Web of Science research areas
Infectious Diseases
Public, Environmental & Occupational Health
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