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...
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| Veröffentlicht in: | Alcoholism, clinical and experimental research clinical and experimental research, 2013-09, Vol.37 (9), p.1527-1535 |
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| creator | Fuster, Daniel Tsui, Judith I. Cheng, Debbie M. Quinn, Emily K. Bridden, Carly Nunes, David Libman, Howard Saitz, Richard Samet, Jeffrey H. |
| description | 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 |
| doi_str_mv | 10.1111/acer.12129 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3758457</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3057649691</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5199-58cbfae27385ba7de10474abdf14aeeebba96cffeabbbcb31a8e51df8836212e3</originalsourceid><addsrcrecordid>eNp9kU9vEzEQxVcIRNPChQ-ALHFBlbbY6_3jvSCFpU0ihRAhSo-W7R0Tl911sL2FXvnkuEkbAQd8sTXze08zfknyguAzEs8bocCdkYxk9aNkQgqKU5xV1eNkgklepCXG7Cg59v4aY5yzsnyaHGW0zKucsUnya9FvhQrIarQ0GoLpAU07ZTe2Q5cekB1i_QYcujDSWW88MgMSaG23YyeCie2onC--pItBgwrQonUswxA8ujJhg8TQ7h52DGgO29gL0aNBjTU7QXR4ljzRovPw_P4-SS4vzj8383T5cbZopstUFaSu04IpqQVkFWWFFFULBMcdhGw1yQUASCnqUmkNQkqpJCWCQUFazRgt498APUne7n23o-yhVXFIJzq-daYX7pZbYfjfncFs-Fd7w2lVsLyoosHrewNnv4_gA--NV9B1YgA7ek5yWmdZkbM6oq_-Qa_t6Ia4XqQyVpKaVTRSp3tKxa_1DvRhGIL5XbT8Llq-izbCL_8c_4A-ZBkBsgd-mA5u_2PFp835pwfTdK8xPsDPg0a4b7ys4t78ajXjH1az9-_Wq5xT-hu7iMA3</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1428619873</pqid></control><display><type>article</type><title>Impact of Lifetime Alcohol Use on Liver Fibrosis in a Population of HIV-Infected Patients With and Without Hepatitis C Coinfection</title><source>MEDLINE</source><source>Wiley Journals</source><source>Journals@Ovid Complete</source><creator>Fuster, Daniel ; Tsui, Judith I. ; Cheng, Debbie M. ; Quinn, Emily K. ; Bridden, Carly ; Nunes, David ; Libman, Howard ; Saitz, Richard ; Samet, Jeffrey H.</creator><creatorcontrib>Fuster, Daniel ; Tsui, Judith I. ; Cheng, Debbie M. ; Quinn, Emily K. ; Bridden, Carly ; Nunes, David ; Libman, Howard ; Saitz, Richard ; Samet, Jeffrey H.</creatorcontrib><description><![CDATA[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 <1.45 and APRI <0.5 defined the absence of liver fibrosis. FIB‐4 >3.25 and APRI >1.5 defined advanced liver fibrosis. The main independent variable was lifetime alcohol consumption (<150 kg, 150 to 600 kg, >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 <1,000 copies/ml, and 18.7% with a CD4 count <200 cells/mm3. Forty‐five percent had lifetime alcohol consumption >600 kg, 32.7% 150 to 600 kg, and 22.3% <150 kg; 33% had current heavy alcohol use, and 69% had >9 years of heavy episodic drinking. Sixty‐one percent had absence of liver fibrosis and 10% had advanced liver fibrosis based on FIB‐4. In logistic regression analyses, controlling for age, gender, HCV infection, and CD4 count, no association was detected between lifetime alcohol consumption and the absence of liver fibrosis (FIB‐4 <1.45) (adjusted odds ratio [AOR] = 1.12 [95% CI: 0.25 to 2.52] for 150 to 600 kg vs. <150 kg; AOR = 1.11 [95% CI: 0.52 to 2.36] for >600 kg vs. <150 kg; global p = 0.95). Additionally, no association was detected between lifetime alcohol use and advanced liver fibrosis (FIB‐4 >3.25). Results were similar using APRI, and among those with and without HCV infection.
Conclusions
In this cohort of HIV‐infected patients with alcohol problems, we found no significant association between lifetime alcohol consumption and the absence of liver fibrosis or the presence of advanced liver fibrosis, suggesting that alcohol may be less important than other known factors that promote liver fibrosis in this population.]]></description><identifier>ISSN: 0145-6008</identifier><identifier>EISSN: 1530-0277</identifier><identifier>DOI: 10.1111/acer.12129</identifier><identifier>PMID: 23647488</identifier><identifier>CODEN: ACRSDM</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Adult ; Age ; Alcohol ; Alcohol Drinking - epidemiology ; Alcohol Drinking - pathology ; Alcoholism - diagnosis ; Alcoholism - epidemiology ; Cohort Studies ; Coinfection - diagnosis ; Coinfection - epidemiology ; Cross-Sectional Studies ; Female ; Hepatitis C - diagnosis ; Hepatitis C - epidemiology ; Hepatitis C Virus ; HIV ; HIV Infections - diagnosis ; HIV Infections - epidemiology ; Humans ; Liver Cirrhosis - diagnosis ; Liver Cirrhosis - epidemiology ; Liver Fibrosis ; Longitudinal Studies ; Male ; Middle Aged ; Population Surveillance - methods ; Prospective Studies</subject><ispartof>Alcoholism, clinical and experimental research, 2013-09, Vol.37 (9), p.1527-1535</ispartof><rights>Copyright © 2013 by the Research Society on Alcoholism</rights><rights>Copyright © 2013 by the Research Society on Alcoholism.</rights><rights>2013 Research Society on Alcoholism</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5199-58cbfae27385ba7de10474abdf14aeeebba96cffeabbbcb31a8e51df8836212e3</citedby><cites>FETCH-LOGICAL-c5199-58cbfae27385ba7de10474abdf14aeeebba96cffeabbbcb31a8e51df8836212e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Facer.12129$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Facer.12129$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,780,784,885,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23647488$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fuster, Daniel</creatorcontrib><creatorcontrib>Tsui, Judith I.</creatorcontrib><creatorcontrib>Cheng, Debbie M.</creatorcontrib><creatorcontrib>Quinn, Emily K.</creatorcontrib><creatorcontrib>Bridden, Carly</creatorcontrib><creatorcontrib>Nunes, David</creatorcontrib><creatorcontrib>Libman, Howard</creatorcontrib><creatorcontrib>Saitz, Richard</creatorcontrib><creatorcontrib>Samet, Jeffrey H.</creatorcontrib><title>Impact of Lifetime Alcohol Use on Liver Fibrosis in a Population of HIV-Infected Patients With and Without Hepatitis C Coinfection</title><title>Alcoholism, clinical and experimental research</title><addtitle>Alcohol Clin Exp Res</addtitle><description><![CDATA[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 <1.45 and APRI <0.5 defined the absence of liver fibrosis. FIB‐4 >3.25 and APRI >1.5 defined advanced liver fibrosis. The main independent variable was lifetime alcohol consumption (<150 kg, 150 to 600 kg, >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 <1,000 copies/ml, and 18.7% with a CD4 count <200 cells/mm3. Forty‐five percent had lifetime alcohol consumption >600 kg, 32.7% 150 to 600 kg, and 22.3% <150 kg; 33% had current heavy alcohol use, and 69% had >9 years of heavy episodic drinking. Sixty‐one percent had absence of liver fibrosis and 10% had advanced liver fibrosis based on FIB‐4. In logistic regression analyses, controlling for age, gender, HCV infection, and CD4 count, no association was detected between lifetime alcohol consumption and the absence of liver fibrosis (FIB‐4 <1.45) (adjusted odds ratio [AOR] = 1.12 [95% CI: 0.25 to 2.52] for 150 to 600 kg vs. <150 kg; AOR = 1.11 [95% CI: 0.52 to 2.36] for >600 kg vs. <150 kg; global p = 0.95). Additionally, no association was detected between lifetime alcohol use and advanced liver fibrosis (FIB‐4 >3.25). Results were similar using APRI, and among those with and without HCV infection.
Conclusions
In this cohort of HIV‐infected patients with alcohol problems, we found no significant association between lifetime alcohol consumption and the absence of liver fibrosis or the presence of advanced liver fibrosis, suggesting that alcohol may be less important than other known factors that promote liver fibrosis in this population.]]></description><subject>Adult</subject><subject>Age</subject><subject>Alcohol</subject><subject>Alcohol Drinking - epidemiology</subject><subject>Alcohol Drinking - pathology</subject><subject>Alcoholism - diagnosis</subject><subject>Alcoholism - epidemiology</subject><subject>Cohort Studies</subject><subject>Coinfection - diagnosis</subject><subject>Coinfection - epidemiology</subject><subject>Cross-Sectional Studies</subject><subject>Female</subject><subject>Hepatitis C - diagnosis</subject><subject>Hepatitis C - epidemiology</subject><subject>Hepatitis C Virus</subject><subject>HIV</subject><subject>HIV Infections - diagnosis</subject><subject>HIV Infections - epidemiology</subject><subject>Humans</subject><subject>Liver Cirrhosis - diagnosis</subject><subject>Liver Cirrhosis - epidemiology</subject><subject>Liver Fibrosis</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Population Surveillance - methods</subject><subject>Prospective Studies</subject><issn>0145-6008</issn><issn>1530-0277</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU9vEzEQxVcIRNPChQ-ALHFBlbbY6_3jvSCFpU0ihRAhSo-W7R0Tl911sL2FXvnkuEkbAQd8sTXze08zfknyguAzEs8bocCdkYxk9aNkQgqKU5xV1eNkgklepCXG7Cg59v4aY5yzsnyaHGW0zKucsUnya9FvhQrIarQ0GoLpAU07ZTe2Q5cekB1i_QYcujDSWW88MgMSaG23YyeCie2onC--pItBgwrQonUswxA8ujJhg8TQ7h52DGgO29gL0aNBjTU7QXR4ljzRovPw_P4-SS4vzj8383T5cbZopstUFaSu04IpqQVkFWWFFFULBMcdhGw1yQUASCnqUmkNQkqpJCWCQUFazRgt498APUne7n23o-yhVXFIJzq-daYX7pZbYfjfncFs-Fd7w2lVsLyoosHrewNnv4_gA--NV9B1YgA7ek5yWmdZkbM6oq_-Qa_t6Ia4XqQyVpKaVTRSp3tKxa_1DvRhGIL5XbT8Llq-izbCL_8c_4A-ZBkBsgd-mA5u_2PFp835pwfTdK8xPsDPg0a4b7ys4t78ajXjH1az9-_Wq5xT-hu7iMA3</recordid><startdate>201309</startdate><enddate>201309</enddate><creator>Fuster, Daniel</creator><creator>Tsui, Judith I.</creator><creator>Cheng, Debbie M.</creator><creator>Quinn, Emily K.</creator><creator>Bridden, Carly</creator><creator>Nunes, David</creator><creator>Libman, Howard</creator><creator>Saitz, Richard</creator><creator>Samet, Jeffrey H.</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>K7.</scope><scope>K9.</scope><scope>7U9</scope><scope>H94</scope><scope>5PM</scope></search><sort><creationdate>201309</creationdate><title>Impact of Lifetime Alcohol Use on Liver Fibrosis in a Population of HIV-Infected Patients With and Without Hepatitis C Coinfection</title><author>Fuster, Daniel ; Tsui, Judith I. ; Cheng, Debbie M. ; Quinn, Emily K. ; Bridden, Carly ; Nunes, David ; Libman, Howard ; Saitz, Richard ; Samet, Jeffrey H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5199-58cbfae27385ba7de10474abdf14aeeebba96cffeabbbcb31a8e51df8836212e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult</topic><topic>Age</topic><topic>Alcohol</topic><topic>Alcohol Drinking - epidemiology</topic><topic>Alcohol Drinking - pathology</topic><topic>Alcoholism - diagnosis</topic><topic>Alcoholism - epidemiology</topic><topic>Cohort Studies</topic><topic>Coinfection - diagnosis</topic><topic>Coinfection - epidemiology</topic><topic>Cross-Sectional Studies</topic><topic>Female</topic><topic>Hepatitis C - diagnosis</topic><topic>Hepatitis C - epidemiology</topic><topic>Hepatitis C Virus</topic><topic>HIV</topic><topic>HIV Infections - diagnosis</topic><topic>HIV Infections - epidemiology</topic><topic>Humans</topic><topic>Liver Cirrhosis - diagnosis</topic><topic>Liver Cirrhosis - epidemiology</topic><topic>Liver Fibrosis</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Population Surveillance - methods</topic><topic>Prospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fuster, Daniel</creatorcontrib><creatorcontrib>Tsui, Judith I.</creatorcontrib><creatorcontrib>Cheng, Debbie M.</creatorcontrib><creatorcontrib>Quinn, Emily K.</creatorcontrib><creatorcontrib>Bridden, Carly</creatorcontrib><creatorcontrib>Nunes, David</creatorcontrib><creatorcontrib>Libman, Howard</creatorcontrib><creatorcontrib>Saitz, Richard</creatorcontrib><creatorcontrib>Samet, Jeffrey H.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Criminal Justice (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Alcoholism, clinical and experimental research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fuster, Daniel</au><au>Tsui, Judith I.</au><au>Cheng, Debbie M.</au><au>Quinn, Emily K.</au><au>Bridden, Carly</au><au>Nunes, David</au><au>Libman, Howard</au><au>Saitz, Richard</au><au>Samet, Jeffrey H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of Lifetime Alcohol Use on Liver Fibrosis in a Population of HIV-Infected Patients With and Without Hepatitis C Coinfection</atitle><jtitle>Alcoholism, clinical and experimental research</jtitle><addtitle>Alcohol Clin Exp Res</addtitle><date>2013-09</date><risdate>2013</risdate><volume>37</volume><issue>9</issue><spage>1527</spage><epage>1535</epage><pages>1527-1535</pages><issn>0145-6008</issn><eissn>1530-0277</eissn><coden>ACRSDM</coden><abstract><![CDATA[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 <1.45 and APRI <0.5 defined the absence of liver fibrosis. FIB‐4 >3.25 and APRI >1.5 defined advanced liver fibrosis. The main independent variable was lifetime alcohol consumption (<150 kg, 150 to 600 kg, >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 <1,000 copies/ml, and 18.7% with a CD4 count <200 cells/mm3. Forty‐five percent had lifetime alcohol consumption >600 kg, 32.7% 150 to 600 kg, and 22.3% <150 kg; 33% had current heavy alcohol use, and 69% had >9 years of heavy episodic drinking. Sixty‐one percent had absence of liver fibrosis and 10% had advanced liver fibrosis based on FIB‐4. In logistic regression analyses, controlling for age, gender, HCV infection, and CD4 count, no association was detected between lifetime alcohol consumption and the absence of liver fibrosis (FIB‐4 <1.45) (adjusted odds ratio [AOR] = 1.12 [95% CI: 0.25 to 2.52] for 150 to 600 kg vs. <150 kg; AOR = 1.11 [95% CI: 0.52 to 2.36] for >600 kg vs. <150 kg; global p = 0.95). Additionally, no association was detected between lifetime alcohol use and advanced liver fibrosis (FIB‐4 >3.25). Results were similar using APRI, and among those with and without HCV infection.
Conclusions
In this cohort of HIV‐infected patients with alcohol problems, we found no significant association between lifetime alcohol consumption and the absence of liver fibrosis or the presence of advanced liver fibrosis, suggesting that alcohol may be less important than other known factors that promote liver fibrosis in this population.]]></abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>23647488</pmid><doi>10.1111/acer.12129</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0145-6008 |
| ispartof | Alcoholism, clinical and experimental research, 2013-09, Vol.37 (9), p.1527-1535 |
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| language | eng |
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| source | MEDLINE; Wiley Journals; Journals@Ovid Complete |
| subjects | Adult Age Alcohol Alcohol Drinking - epidemiology Alcohol Drinking - pathology Alcoholism - diagnosis Alcoholism - epidemiology Cohort Studies Coinfection - diagnosis Coinfection - epidemiology Cross-Sectional Studies Female Hepatitis C - diagnosis Hepatitis C - epidemiology Hepatitis C Virus HIV HIV Infections - diagnosis HIV Infections - epidemiology Humans Liver Cirrhosis - diagnosis Liver Cirrhosis - epidemiology Liver Fibrosis Longitudinal Studies Male Middle Aged Population Surveillance - methods Prospective Studies |
| title | Impact of Lifetime Alcohol Use on Liver Fibrosis in a Population of HIV-Infected Patients With and Without Hepatitis C Coinfection |
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