Erin M Kelly1, Jennifer L Dodge2, Peter Bacchetti3, Monika Sarkar4, Audrey L French5, Phyllis C Tien4,6, Marshall J Glesby7, Elizabeth T Golub8, Michael Augenbraun9, Michael Plankey10, Marion G Peters4. 1. Department of Medicine, University of Ottawa, Ontario, Canada. 2. Surgery. 3. Epidemiology and Biostatistics. 4. Medicine, University of California, San Francisco. 5. Department of Medicine, CORE Center/Stroger Hospital of Cook County, Chicago, Illinois. 6. Department of Veterans Affairs Medical Center, San Francisco, California. 7. Department of Medicine, Weill Cornell Medical College, New York, New York. 8. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. 9. Department of Medicine, State University of New York, Downstate Medical Center, Brooklyn. 10. Department of Medicine, Georgetown University Medical Center, Washington, District of Columbia.
Abstract
BACKGROUND: Heavy alcohol use can lead to progressive liver damage, especially in individuals with chronic hepatitis C (HCV); however, the impact of nonheavy use is not clear. We studied long-term effects of modest alcohol use on fibrosis progression in a large cohort of women coinfected with human immunodeficiency virus (HIV)/HCV. METHODS: Alcohol intake was ascertained every 6 months and use categorized as abstinent, light (1-3 drinks/week), moderate (4-7 drinks/week), heavy (>7 drinks/week), and very heavy (>14 drinks/week). Fibrosis progression was defined as the change in Fibrosis-4 Index for Liver Fibrosis (FIB-4) units per year using random-intercept, random-slope mixed modeling. RESULTS: Among 686 HIV/HCV-coinfected women, 46.0% reported no alcohol use; 26.8% reported light use, 7.1% moderate use, and 19.7% heavy use (6.7% had 8-14 drinks/week and 13.0% had >14 drinks/week) at cohort entry. Median FIB-4 at entry was similar between groups. On multivariable analysis, compared to abstainers, light and moderate alcohol use was not associated with fibrosis progression (0.004 [95% confidence interval {CI}, -.11 to .12] and 0.006 [95% CI, -.18 to .19] FIB-4 units/year, respectively). Very heavy drinking (>14 drinks/week) showed significant fibrosis acceleration (0.25 [95% CI, .01-.49] FIB-4 units/year) compared to abstaining, whereas drinking 8-14 drinks per week showed minimal acceleration of fibrosis progression (0.04 [95% CI, -.19 to .28] FIB-4 units/year). CONCLUSIONS: Light/moderate alcohol use was not substantially associated with accelerated fibrosis progression, whereas drinking >14 drinks per week showed increased rates of fibrosis progression. Women with HIV/HCV infection should be counseled against heavy alcohol consumption, but complete abstinence may not be required to prevent accelerated liver fibrosis progression.
BACKGROUND: Heavy alcohol use can lead to progressive liver damage, especially in individuals with chronic hepatitis C (HCV); however, the impact of nonheavy use is not clear. We studied long-term effects of modest alcohol use on fibrosis progression in a large cohort of women coinfected with human immunodeficiency virus (HIV)/HCV. METHODS: Alcohol intake was ascertained every 6 months and use categorized as abstinent, light (1-3 drinks/week), moderate (4-7 drinks/week), heavy (>7 drinks/week), and very heavy (>14 drinks/week). Fibrosis progression was defined as the change in Fibrosis-4 Index for Liver Fibrosis (FIB-4) units per year using random-intercept, random-slope mixed modeling. RESULTS: Among 686 HIV/HCV-coinfected women, 46.0% reported no alcohol use; 26.8% reported light use, 7.1% moderate use, and 19.7% heavy use (6.7% had 8-14 drinks/week and 13.0% had >14 drinks/week) at cohort entry. Median FIB-4 at entry was similar between groups. On multivariable analysis, compared to abstainers, light and moderate alcohol use was not associated with fibrosis progression (0.004 [95% confidence interval {CI}, -.11 to .12] and 0.006 [95% CI, -.18 to .19] FIB-4 units/year, respectively). Very heavy drinking (>14 drinks/week) showed significant fibrosis acceleration (0.25 [95% CI, .01-.49] FIB-4 units/year) compared to abstaining, whereas drinking 8-14 drinks per week showed minimal acceleration of fibrosis progression (0.04 [95% CI, -.19 to .28] FIB-4 units/year). CONCLUSIONS: Light/moderate alcohol use was not substantially associated with accelerated fibrosis progression, whereas drinking >14 drinks per week showed increased rates of fibrosis progression. Women with HIV/HCV infection should be counseled against heavy alcohol consumption, but complete abstinence may not be required to prevent accelerated liver fibrosis progression.
Authors: Robyn C Neblett; Heidi E Hutton; Bryan Lau; Mary E McCaul; Richard D Moore; Geetanjali Chander Journal: J Womens Health (Larchmt) Date: 2011-01-31 Impact factor: 2.681
Authors: Salvador Resino; Cristina Asensio; José María Bellón; Rocío Carmona; Pilar Miralles; Juan Carlos López; Jaime Cosín; Emilio Álvarez; Juan Berenguer Journal: J Infect Date: 2011-08-03 Impact factor: 6.072
Authors: Richard K Sterling; R Todd Stravitz; Velimir A Luketic; Arun J Sanyal; Melissa J Contos; A Scott Mills; Mitchell L Shiffman Journal: Clin Gastroenterol Hepatol Date: 2004-06 Impact factor: 11.382
Authors: Monika Sarkar; Peter Bacchetti; Phyllis Tien; Elizabeth Mileti; Audrey L French; Brian R Edlin; Marla Keller; Eric Seaberg; Marek J Nowicki; Mary Young; Marion G Peters Journal: Dig Dis Sci Date: 2012-11-24 Impact factor: 3.199
Authors: A H Mohsen; P J Easterbrook; C Taylor; B Portmann; R Kulasegaram; S Murad; M Wiselka; S Norris Journal: Gut Date: 2003-07 Impact factor: 23.059
Authors: Natalie E Chichetto; Brittanny M Polanka; Kaku A So-Armah; Minhee Sung; Jesse C Stewart; John R Koethe; E Jennifer Edelman; Hilary A Tindle; Matthew S Freiberg Journal: Curr HIV/AIDS Rep Date: 2020-08 Impact factor: 5.495
Authors: Ralph J DiClemente; Jennifer L Brown; Ariadna Capasso; Natalia Revzina; Jessica M Sales; Ekaterina Boeva; Lyudmila V Gutova; Nadia B Khalezova; Nikolay Belyakov; Vadim Rassokhin Journal: Trials Date: 2021-02-17 Impact factor: 2.279