Is physician assessment of alcohol consumption useful in predicting risk of severe liver disease among people with HIV and HIV/HCV co-infection?

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RESEARCH PRODUCT

Is physician assessment of alcohol consumption useful in predicting risk of severe liver disease among people with HIV and HIV/HCV co-infection?

M. Shanyinde E. Girardi M. Puoti A. De Luca L. Sighinolfi U. F. Caterina P. Caramello F. C. Lampe A. D'arminio Monforte A. Cozzi-lepri A. D'arminio Monforte M. Andreoni G. Angarano A. Antinori F. Castelli R. Cauda G. Di Perri M. Galli R. Iardino G. Ippolito A. Lazzarin C. F. Perno F. Von Schloesser P. Viale A. Castagna F. Ceccherini-silberstein A. Cozzi-lepri E. Girardi S. L. Caputo C. Mussini M. Puoti A. Ammassari C. Balotta A. Bandera P. Bonfanti S. Bonora M. Borderi A. Calcagno L. Calza M. R. Capobianchi A. Cingolani P. Cinque A. De Luca A. Di Biagio N. Gianotti A. Gori G. Guaraldi G. Lapadula M. Lichtner G. Madeddu F. Maggiolo G. Marchetti S. Marcotullio L. Monno S. Nozza E. Q. Roldan R. Rossotti S. Rusconi M. M. Santoro A. Saracino M. Zaccarelli I. Fanti L. Galli P. Lorenzini A. Rodano M. Shanyinde A. Tavelli F. Carletti S. Carrara A. Di Caro S. Graziano F. Petrone G. Prota S. Quartu S. Truffa A. Giacometti A. Costantini C. Valeriani C. Santoro C. Suardi V. Donati G. Verucchi C. Minardi T. Quirino C. Abeli P. E. Manconi P. Piano B. Cacopardo B. Celesia J. Vecchiet K. Falasca L. Sighinolfi D. Segala F. Mazzotta F. Vichi G. Cassola C. Viscoli A. Alessandrini N. Bobbio G. Mazzarello C. Mastroianni V. Belvisi I. Caramma A. Chiodera P. Milini G. Rizzardini A. L. Ridolfo R. Piolini S. Salpietro L. Carenzi M. C. Moioli C. Tincati C. Puzzolante N. Abrescia A. Chirianni G. Borgia R. Orlando F. Di Martino L. Maddaloni I. Gentile G. Bonadies A. Cascio C. Colomba F. Baldelli E. Schiaroli G. Parruti T. Ursini G. Magnani M. A. Ursitti V. Vullo A. Cristaudo G. Baldin S. Cicalini L. Gallo E. Nicastri R. Acinapura M. Capozzi R. Libertone S. Savinelli A. Latini G. Iaiani L. F. Sulekova M. Cecchetto F. Viviani M. S. Mura B. Rossetti D. Francisci C. Di Giuli P. Caramello G. C. Orofino M. Sciandra M. Bassetti A. Londero G. Pellizzer V. Manfrin

subject

Male 030508 substance abuse HIV Infections Severity of Illness Index Cohort Studies Liver disease 0302 clinical medicine Risk Factors Epidemiology Medicine HIV Infection Alcohol consumption Alcohol consumption HIV-infected HIV/HCV co-infection Severe liver disease 030212 general & internal medicine education.field_of_study Coinfection Liver Disease lcsh:Public aspects of medicine Liver Diseases Hazard ratio Hepatitis C Middle Aged Hepatitis C Italy alcohol consumption; HIV-infected; HIV/HCV co-infection; severe liver disease Coinfection Female 0305 other medical science Human Cohort study Research Article Adult medicine.medical_specialty Alcohol Drinking Population Severe liver disease HIV/HCV co-infection NO 03 medical and health sciences Environmental health Humans Risk factor Alcohol consumption; HIV-infected; HIV/HCV co-infection; Severe liver disease; Adult; Alcohol Drinking; Cohort Studies; Female; HIV Infections; Hepatitis C; Humans; Italy; Liver Diseases; Male; Middle Aged; Risk Factors; Severity of Illness Index; Coinfection education HIV-infected business.industry Risk Factor Public Health Environmental and Occupational Health lcsh:RA1-1270 medicine.disease Cohort Studie business

description

AbstractBackgroundAlcohol consumption is a known risk factor for liver disease in HIV-infected populations. Therefore, knowledge of alcohol consumption behaviour and risk of disease progression associated with hazardous drinking are important in the overall management of HIV disease. We aimed at assessing the usefulness of routine data collected on alcohol consumption in predicting risk of severe liver disease (SLD) among people living with HIV (PLWHIV) with or without hepatitis C infection seen for routine clinical care in Italy.MethodsWe included PLWHIV from two observational cohorts in Italy (ICONA and HepaICONA). Alcohol consumption was assessed by physician interview and categorized according to the National Institute for Food and Nutrition Italian guidelines into four categories: abstainer; moderate; hazardous and unknown. SLD was defined as presence of FIB4 > 3.25 or a clinical diagnosis of liver disease or liver-related death. Cox regression analysis was used to evaluate the association between level of alcohol consumption at baseline and risk of SLD.ResultsAmong 9542 included PLWHIV the distribution of alcohol consumption categories was: abstainers 3422 (36%), moderate drinkers 2279 (23%), hazardous drinkers 637 (7%) and unknown 3204 (34%). Compared to moderate drinkers, hazardous drinking was associated with higher risk of SLD (adjusted hazard ratio, aHR = 1.45; 95% CI: 1.03–2.03). After additionally controlling for mode of HIV transmission, HCV infection and smoking, the association was attenuated (aHR = 1.32; 95% CI: 0.94–1.85). There was no evidence that the association was stronger when restricting to the HIV/HCV co-infected population.ConclusionsUsing a brief physician interview, we found evidence for an association between hazardous alcohol consumption and subsequent risk of SLD among PLWHIV, but this was not independent of HIV mode of transmission, HCV-infection and smoking. More efforts should be made to improve quality and validity of data on alcohol consumption in cohorts of HIV/HCV-infected individuals.

year	journal	country	edition	language
2019-10-01	BMC Public Health

10.1186/s12889-019-7608-1 http://europepmc.org/articles/PMC6794785