Impact of Lifetime Alcohol Use on Liver Fibrosis in a Population of HIV-Infected Patients With and Without Hepatitis C Coinfection

Background The effect of alcohol on liver disease in HIV infection has not been well characterized. Methods We performed a cross‐sectional multivariable analysis of the association between lifetime alcohol use and liver fibrosis in a longitudinal cohort of HIV‐infected patients with alcohol problems. Liver fibrosis was estimated with 2 noninvasive indices, “FIB‐4,” which includes platelets, liver enzymes, and age; and aspartate aminotransferase/platelet ratio index (“APRI”), which includes platelets and liver enzymes. FIB‐4 1.5 defined advanced liver fibrosis. The main independent variable was lifetime alcohol consumption (600 kg). Results Subjects (n = 308) were 73% men, mean age 43 years, 49% with hepatitis C virus (HCV) infection, 60% on antiretroviral therapy, 49% with an HIV RNA load