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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 2050-2056 |
| Number of pages | 7 |
| Journal | Clinical Infectious Diseases |
| Volume | 65 |
| Issue number | 12 |
| DOIs | |
| State | Published - Dec 15 2017 |
Funding
Women's Interagency HIV Study. U01-AI-103408 (National Institutes of Health [NIH]); Bronx WIHS (Principal Investigator [PI], Kathryn Anastos), U01-AI-035004; Brooklyn WIHS (PIs, Howard Minkoff and Deborah Gustafson), U01-AI-031834; Chicago WIHS (PIs, Mardge Cohen and Audrey French), U01-AI-034993; Metropolitan Washington WIHS (PIs, Mary Young and Seble Kassaye), U01-AI-034994; Connie Wofsy Women's HIV Study, Northern California (PIs, Ruth Greenblatt, Bradley Aouizerat, and Phyllis Tien), U01-AI-034989; WIHS Data Management and Analysis Center (PIs, Stephen Gange and Elizabeth Golub), U01-AI-042590; Southern California WIHS (PIs, Alexandra Levine and Marek Nowicki), U01-HD-032632 (WIHS I-WIHS IV). Disclaimer. The contents of this publication are solely the responsibility of the authors and do not represent the official views of the National Institutes of Health (NIH). Financial support. The WIHS is funded by the National Institute of Allergy and Infectious Diseases (NIAID) (grant numbers U01-AI-103401, U01-AI-103408, U01-AI-35004, U01-AI-31834, U01-AI-34994, U01-AI-103397, U01-AI-103390, U01-AI-34989, and U01-AI-42590), with additional co-funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Cancer Institute, the National Institute on Drug Abuse, and the National Institute of Mental Health. Targeted supplemental funding for specific projects is also provided by the National Institute of Dental and Craniofacial Research, the National Institute on Alcohol Abuse and Alcoholism, the National Institute on Deafness and Other Communication Disorders, and the NIH Office of Research on Women's Health. WIHS data collection is also supported by the University of California, San Francisco (UCSF) Clinical and Translational Science Awards (CTSA) (number UL1-TR000004); and Atlanta CTSA (number UL1-TR000454). The study was also supported by the UCSF Liver Center Biostatistics Core, NIH (grant number P30 DK026743) and by the NIAID (grant numbers R21 AI088351[MGP], K24 AI 108516, and R01 AI 087176 to P. C. T., which was administered by the Northern California Institute for Research and Education, and with resources of the Veterans Affairs Medical Center, San Francisco, California). Financial support. The WIHS is funded by the National Institute of Allergy and Infectious Diseases (NIAID) (grant numbers U01-AI-103401, U01-AI-103408, U01-AI-35004, U01-AI-31834, U01-AI-34994, U01-AI-103397, U01-AI-103390, U01-AI-34989, and U01-AI-42590), with additional co-funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Cancer Institute, the National Institute on Drug Abuse, and the National Institute of Mental Health. Targeted supplemental funding for specific projects is also provided by the National Institute of Dental and Craniofacial Research, the National Institute on Alcohol Abuse and Alcoholism, the National Institute on Deafness and Other Communication Disorders, and the NIH Office of Research on Women’s Health. WIHS data collection is also supported by the University of California, San Francisco (UCSF) Clinical and Translational Science Awards (CTSA) (number UL1-TR000004); and Atlanta CTSA (number UL1-TR000454). The study was also supported by the UCSF Liver Center Biostatistics Core, NIH (grant number P30 DK026743) and by the NIAID (grant numbers R21 AI088351[MGP], K24 AI 108516, and R01 AI 087176 to P. C. T., which was administered by the Northern California Institute for Research and Education, and with resources of the Veterans Affairs Medical Center, San Francisco, California).
Keywords
- FIB-4
- alcohol
- coinfection
- fibrosis
- hepatitis C
ASJC Scopus subject areas
- Microbiology (medical)
- Infectious Diseases
