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.

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

Calza L.;Verucchi G.
Membro del Collaboration Group
;
2019

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.
Shanyinde M.; Girardi E.; Puoti M.; De Luca A.; Sighinolfi L.; Caterina U.F.; Caramello P.; Lampe F.C.; D'Arminio Monforte A.; Cozzi-Lepri A.; Andreoni M.; Angarano G.; Antinori A.; Castelli F.; Cauda R.; Di Perri G.; Galli M.; Iardino R.; Ippolito G.; Lazzarin A.; Perno C.F.; Von Schloesser F.; Viale P.; Castagna A.; Ceccherini-Silberstein F.; Caputo S.L.; Mussini C.; Ammassari A.; Balotta C.; Bandera A.; Bonfanti P.; Bonora S.; Borderi M.; Calcagno A.; Calza L.; Capobianchi M.R.; Cingolani A.; Cinque P.; Di Biagio A.; Gianotti N.; Gori A.; Guaraldi G.; Lapadula G.; Lichtner M.; Madeddu G.; Maggiolo F.; Marchetti G.; Marcotullio S.; Monno L.; Nozza S.; Roldan E.Q.; Rossotti R.; Rusconi S.; Santoro M.M.; Saracino A.; Zaccarelli M.; Fanti I.; Galli L.; Lorenzini P.; Rodano A.; Tavelli A.; Carletti F.; Carrara S.; Di Caro A.; Graziano S.; Petrone F.; Prota G.; Quartu S.; Truffa S.; Giacometti A.; Costantini A.; Valeriani C.; Santoro C.; Suardi C.; Donati V.; Verucchi G.; Minardi C.; Quirino T.; Abeli C.; Manconi P.E.; Piano P.; Cacopardo B.; Celesia B.; Vecchiet J.; Falasca K.; Segala D.; Mazzotta F.; Vichi F.; Cassola G.; Viscoli C.; Alessandrini A.; Bobbio N.; Mazzarello G.; Mastroianni C.; Belvisi V.; Caramma I.; Chiodera A.; Milini P.; Rizzardini G.; Ridolfo A.L.; Piolini R.; Salpietro S.; Carenzi L.; Moioli M.C.; Tincati C.; Puzzolante C.; Abrescia N.; Chirianni A.; Borgia G.; Orlando R.; Di Martino F.; Maddaloni L.; Gentile I.; Bonadies G.; Cascio A.; Colomba C.; Baldelli F.; Schiaroli E.; Parruti G.; Ursini T.; Magnani G.; Ursitti M.A.; Vullo V.; Cristaudo A.; Baldin G.; Cicalini S.; Gallo L.; Nicastri E.; Acinapura R.; Capozzi M.; Libertone R.; Savinelli S.; Latini A.; Iaiani G.; Sulekova L.F.; Cecchetto M.; Viviani F.; Mura M.S.; Rossetti B.; Francisci D.; Di Giuli C.; Orofino G.C.; Sciandra M.; Bassetti M.; Londero A.; Pellizzer G.; Manfrin V.
File in questo prodotto:
File Dimensione Formato  
Shanyinde et al. BMC Public Health (2019) 19-1291 Page 12 of 13.pdf

accesso aperto

Tipo: Versione (PDF) editoriale
Licenza: Licenza per Accesso Aperto. Creative Commons Attribuzione (CCBY)
Dimensione 991.22 kB
Formato Adobe PDF
991.22 kB Adobe PDF Visualizza/Apri
12889_2019_7608_MOESM1_ESM.docx

accesso aperto

Descrizione: Additional file 1. Table S1. List of Ethic Committees that Approved Icona Study.
Tipo: File Supplementare
Licenza: Licenza per Accesso Aperto. Altra tipologia di licenza compatibile con Open Access
Dimensione 22.36 kB
Formato Microsoft Word XML
22.36 kB Microsoft Word XML Visualizza/Apri
12889_2019_7608_MOESM2_ESM.docx

accesso aperto

Descrizione: Additional file 2. Table S2. Patients’ characteristics stratified by reported and non-reported alcohol consumption.
Tipo: File Supplementare
Licenza: Licenza per Accesso Aperto. Altra tipologia di licenza compatibile con Open Access
Dimensione 21.32 kB
Formato Microsoft Word XML
21.32 kB Microsoft Word XML Visualizza/Apri

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11585/733066
Citazioni
  • ???jsp.display-item.citation.pmc??? 3
  • Scopus 4
  • ???jsp.display-item.citation.isi??? 4
social impact