Long-term alcohol use patterns and HIV disease severity
Year: 2017
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: We examined the relationship between alcohol use trajectories and HIV disease severity among men and women participating in the Veterans Aging Cohort Study (VACS). DESIGN: Prospective cohort of HIV-infected persons in care at eight US Veterans Health Administration sites. METHODS: Between 2002 and 2010, we assessed alcohol consumption annually using the alcohol use disorders identification test-consumption (AUDIT-C). HIV disease severity was ascertained using the VACS index, a validated measure of morbidity and all-cause mortality. We examined the relationship between alcohol use and HIV disease severity patterns using joint trajectory modeling. Alcohol use trajectories were validated using phosphatidylethanol - a biomarker of alcohol consumption - measured between 2005 and 2006 among a subset of participants. We examined associations between membership in alcohol use and VACS index trajectories using multinomial regression. RESULTS: Among eligible participants, we identified four alcohol consumption trajectories: abstainers (24% of the sample), lower risk (44%), moderate risk (24%), and higher risk drinkers (8%). Alcohol use trajectories were highly correlated with phosphatidylethanol (Cramér's V = 0.465, P < 0.001): mean concentrations were 4.4, 17.8, 57.7, and 167.6 ng/ml in the abstainer, lower risk, moderate risk, and higher risk groups, respectively. Four VACS index trajectories were identified: low (2%), moderate (46%), high (36%), and extreme (16%). Higher risk drinkers were most common in the extreme VACS index group, and were absent in the low index group. In multivariable analysis, the association between alcohol use and VACS index trajectory membership remained significant (P = 0.002). CONCLUSION: Alcohol use trajectories characterized by persistent unhealthy drinking are associated with more advanced HIV disease severity among HIV-infected veterans in the United States.
Source: AIDS
Language: English
Topic: HIV, Drug Use, Sexual Risk
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: Chronic Opioid Therapy and Patient Safety in HIV Infected and Uninfected Veterans, Using the VACS Index to track health outcomes associated with changes in drug use, 2/6 COMpAAAS U01: Observation Study, 3/6 COMpAAAS U01: Intervention Study, Alcohol Associated Outcomes Among HIV+/- Aging Veterans, Addressing alcohol misuse in HIV prevention and care: The Brown University Alcohol Research Center on HIV (ARCH), Southern HIV and Alcohol Research Consortium Administrative and Research Support Core, 1/6 COMpAAAS U24: Coordinating Center, Minority Populations Resource Core, Highly Adaptive Epidemic Control Strategies for HIV Prevention in Drug Users, Providence/Boston Center for AIDS Research (CFAR), Yale-Drug use, Addiction, and HIV prevention Research Scholars (Yale-DAHRS), Yale Clinical and Translational Science Award
OpenAlex ID: W2599684057