Abstract

Background: Alcohol 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. Methods: We 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. Results: Among 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. Conclusions: Using 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.

Original languageEnglish
Article number1291
Pages (from-to)1-13
Number of pages13
JournalBMC Public Health
Volume19
Issue number1
DOIs
Publication statusPublished - Oct 15 2019

Fingerprint

Coinfection
Alcohol Drinking
Liver Diseases
HIV
Physicians
Infectious Disease Transmission
Italy
Drinking
Smoking
Interviews
Nutrition Policy
Hepatitis C
Disease Management
Risk-Taking
Population
Disease Progression
Regression Analysis
Food
Liver
Infection

Keywords

  • Alcohol consumption
  • HIV-infected
  • HIV/HCV co-infection
  • Severe liver disease

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

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

In: BMC Public Health, Vol. 19, No. 1, 1291, 15.10.2019, p. 1-13.

Research output: Contribution to journalArticle

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title = "Is physician assessment of alcohol consumption useful in predicting risk of severe liver disease among people with HIV and HIV/HCV co-infection?",
abstract = "Background: Alcohol 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. Methods: We 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. Results: Among 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. Conclusions: Using 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.",
keywords = "Alcohol consumption, HIV-infected, HIV/HCV co-infection, Severe liver disease",
author = "{ICONA Foundation Study group} and Milensu Shanyinde and E. Girardi and Massimo Puoti and {De Luca}, Andrea and Laura Sighinolfi and Caterina, {Uberti Foppa} and A. Antinori and R. Cauda and M. Galli and G. Ippolito and A. Lazzarin and Perno, {C. F.} and A. Castagna and E. Girardi and A. Ammassari and A. Calcagno and A. Cingolani and A. Cingolani and P. Cinque and {De Luca}, A. and N. Gianotti and A. Gori and S. Nozza and Santoro, {M. M.} and Santoro, {M. M.} and M. Zaccarelli and L. Galli and P. Lorenzini and A. Rodano and F. Carletti and S. Carrara and {Di Caro}, A. and S. Graziano and G. Prota and S. Quartu and S. Truffa and V. Donati and C. Viscoli and S. Salpietro and G. Magnani and A. Cristaudo and S. Cicalini and E. Nicastri and R. Acinapura and M. Capozzi and R. Libertone and A. Latini and Mura, {M. S.} and B. Rossetti and M. Sciandra",
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T1 - Is physician assessment of alcohol consumption useful in predicting risk of severe liver disease among people with HIV and HIV/HCV co-infection?

AU - ICONA Foundation Study group

AU - Shanyinde, Milensu

AU - Girardi, E.

AU - Puoti, Massimo

AU - De Luca, Andrea

AU - Sighinolfi, Laura

AU - Caterina, Uberti Foppa

AU - Antinori, A.

AU - Cauda, R.

AU - Galli, M.

AU - Ippolito, G.

AU - Lazzarin, A.

AU - Perno, C. F.

AU - Castagna, A.

AU - Girardi, E.

AU - Ammassari, A.

AU - Calcagno, A.

AU - Cingolani, A.

AU - Cingolani, A.

AU - Cinque, P.

AU - De Luca, A.

AU - Gianotti, N.

AU - Gori, A.

AU - Nozza, S.

AU - Santoro, M. M.

AU - Santoro, M. M.

AU - Zaccarelli, M.

AU - Galli, L.

AU - Lorenzini, P.

AU - Rodano, A.

AU - Carletti, F.

AU - Carrara, S.

AU - Di Caro, A.

AU - Graziano, S.

AU - Prota, G.

AU - Quartu, S.

AU - Truffa, S.

AU - Donati, V.

AU - Viscoli, C.

AU - Salpietro, S.

AU - Magnani, G.

AU - Cristaudo, A.

AU - Cicalini, S.

AU - Nicastri, E.

AU - Acinapura, R.

AU - Capozzi, M.

AU - Libertone, R.

AU - Latini, A.

AU - Mura, M. S.

AU - Rossetti, B.

AU - Sciandra, M.

PY - 2019/10/15

Y1 - 2019/10/15

N2 - Background: Alcohol 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. Methods: We 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. Results: Among 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. Conclusions: Using 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.

AB - Background: Alcohol 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. Methods: We 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. Results: Among 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. Conclusions: Using 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.

KW - Alcohol consumption

KW - HIV-infected

KW - HIV/HCV co-infection

KW - Severe liver disease

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