Risha Irvin1, Geetanjali Chander2, Oluwaseun Falade-Nwulia2, Jacquie Astemborski3, Laura Starbird4, Gregory D Kirk5, Mark S Sulkowski2, David L Thomas5, Shruti H Mehta3. 1. Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States. Electronic address: rirvin1@jhmi.edu. 2. Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States. 3. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States. 4. Johns Hopkins School of Nursing, Baltimore, MD, United States. 5. Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
Abstract
BACKGROUND: Alcohol use in people who inject drugs (PWID) with hepatitis C virus (HCV) infection accelerates liver disease progression. This paper describes the prevalence and associated correlates of alcohol use among HCV antibody positive PWID. METHODS: In a large cohort of HCV antibody positive PWID (N = 1623) followed from 2005 to 2013, we characterized alcohol use using the AUDIT-C. We used multivariable logistic regression with generalized estimated equations to examine socio-demographic, clinical, and substance use correlates of alcohol use. RESULTS: At their initial visit, 41% reported no, 21% reported moderate, and 38% reported heavy alcohol use. The odds of moderate and heavy alcohol use increased with greater intensity of substance use represented by a composite summary variable which ranged from 0 to 3 substances (street-acquired prescription drugs, non-injection cocaine/heroin, and injection drugs) used. Compared to those who used no drugs, those who used 3 substances had 3.71 odds (95% CI: 3.07-4.48) of moderate alcohol use and 3.65 odds (95% CI: 3.20-4.16) of heavy alcohol use. CONCLUSIONS: The prevalence of moderate/heavy alcohol use is high among HCV antibody positive PWID and occurs frequently in combination with other drug use. This may contribute to progressive liver fibrosis thus limiting the gains achieved from HCV cure. Public health interventions need to address the overlapping epidemics of HCV, alcohol use, and other substance use in this population.
BACKGROUND: Alcohol use in people who inject drugs (PWID) with hepatitis C virus (HCV) infection accelerates liver disease progression. This paper describes the prevalence and associated correlates of alcohol use among HCV antibody positive PWID. METHODS: In a large cohort of HCV antibody positive PWID (N = 1623) followed from 2005 to 2013, we characterized alcohol use using the AUDIT-C. We used multivariable logistic regression with generalized estimated equations to examine socio-demographic, clinical, and substance use correlates of alcohol use. RESULTS: At their initial visit, 41% reported no, 21% reported moderate, and 38% reported heavy alcohol use. The odds of moderate and heavy alcohol use increased with greater intensity of substance use represented by a composite summary variable which ranged from 0 to 3 substances (street-acquired prescription drugs, non-injection cocaine/heroin, and injection drugs) used. Compared to those who used no drugs, those who used 3 substances had 3.71 odds (95% CI: 3.07-4.48) of moderate alcohol use and 3.65 odds (95% CI: 3.20-4.16) of heavy alcohol use. CONCLUSIONS: The prevalence of moderate/heavy alcohol use is high among HCV antibody positive PWID and occurs frequently in combination with other drug use. This may contribute to progressive liver fibrosis thus limiting the gains achieved from HCV cure. Public health interventions need to address the overlapping epidemics of HCV, alcohol use, and other substance use in this population.
Authors: D L Thomas; J Astemborski; R M Rai; F A Anania; M Schaeffer; N Galai; K Nolt; K E Nelson; S A Strathdee; L Johnson; O Laeyendecker; J Boitnott; L E Wilson; D Vlahov Journal: JAMA Date: 2000-07-26 Impact factor: 56.272
Authors: Brennan M R Spiegel; Zobair M Younossi; Ron D Hays; Dennis Revicki; Sean Robbins; Fasiha Kanwal Journal: Hepatology Date: 2005-04 Impact factor: 17.425
Authors: Jennifer V Campbell; Holly Hagan; Mary H Latka; Richard S Garfein; Elizabeth T Golub; Micaela H Coady; David L Thomas; Steffanie A Strathdee Journal: Drug Alcohol Depend Date: 2005-08-29 Impact factor: 4.492
Authors: Shruti H Mehta; Becky L Genberg; Jacquie Astemborski; Ravi Kavasery; Gregory D Kirk; David Vlahov; Steffanie A Strathdee; David L Thomas Journal: J Community Health Date: 2008-06
Authors: Mark S Sulkowski; Shruti H Mehta; Michael S Torbenson; Yvonne Higgins; Sherilyn C Brinkley; Ruben Montes de Oca; Richard D Moore; Nezam H Afdhal; David L Thomas Journal: AIDS Date: 2007-10-18 Impact factor: 4.177
Authors: Risha Irvin; Geetanjali Chander; Kathleen M Ward; Sean Manogue; Oluwaseun Falade-Nwulia; Juhi Moon; Catherine G Sutcliffe; Sherilyn Brinkley; Taryn Haselhuhn; Stephanie Katz; Kayla Herne; Lilian Arteaga; David L Thomas; Shruti H Mehta; Mark S Sulkowski Journal: J Viral Hepat Date: 2020-01-07 Impact factor: 3.728
Authors: Risha Irvin; Theresa Gamble; Jowanna Malone; Zhe Wang; Ethan Wilson; James P Hughes; Jason Farley; Kenneth H Mayer; Carlos Del Rio; D Scott Batey; Vanessa Cummings; Robert H Remien; Chris Beyrer; Chloe L Thio Journal: Clin Infect Dis Date: 2021-10-05 Impact factor: 20.999