Using Phosphatidylethanol as an Adjunct to Self-Reported Alcohol Use Improves Identification of Liver Fibrosis Risk
Year: 2024
Type: article
Abstract: INTRODUCTION: Accurate assessment of alcohol use informs prevention and management of liver disease. We examined whether phosphatidylethanol (PEth, an alcohol metabolite) blood concentrations are associated with liver fibrosis risk independently of self-reported alcohol use, among persons with and without HIV. METHODS: We pooled individual-level data from 12 studies from the United States, Russia, Uganda, and South Africa with PEth, Alcohol Use Disorders Identification Test-Consumption (AUDIT-C), and fibrosis-4 (FIB-4) measurements. We conducted mixed-effects logistic regression of the relationship between PEth and AUDIT-C as continuous variables (after checking linearity), with high FIB-4 (≥2.67). We divided PEth (range 0-1,000) by 83.3 to put it on the same scale as AUDIT-C (0-12) to directly compare odds ratios. Adjusted models included sex, race/ethnicity, age, body mass index, HIV, and virologic suppression status. RESULTS: Among 4,644 adults, the median age was 49 years (interquartile range [IQR]: 40-55), 998 (21%) were female, and 3,520 (76%) were living with HIV, among whom 2,386 (68%) were virologically suppressed. Median PEth was 13 ng/mL (IQR: <8-132.0) and median AUDIT-C was 3 (IQR: 1-6); 554 (12%) had high FIB-4. The adjusted odds ratios per 83.3 ng/mL difference in PEth and one-unit difference in AUDIT-C with high FIB-4 were 1.15 (95%CI: 1.08-1.22) and 1.03 (95%CI: 1.00-1.07), respectively. Findings were similar when PEth and AUDIT-C were treated as categorical variables. DISCUSSION: PEth was independently associated with high FIB-4, with a larger odds ratio than that of the association of AUDIT-C. The use of PEth may improve identification of alcohol use and liver fibrosis prevention and management.
Authors: Pamela M. Murnane, Majid Afshar, Gabriel Chamie, Robert L. Cook, Tekeda Ferguson, Lamia Y. Haque, Karen R. Jacobson, Amy C. Justice, Theresa W. Kim, Mandana Khalili, Evgeny Krupitsky, Kathleen A. McGinnis, Patricia Molina, Winnie R. Muyindike, Bronwyn Myers, Veronica L. Richards, Kaku So-Armah, Scott Stewart, Mark S. Sulkowski, Phyllis C. Tien, Judith A. Hahn
Institutions: University of California, San Francisco, UCSF Institute for Global Health Sciences, University of Wisconsin–Madison, University of Florida, Louisiana State University Health Sciences Center New Orleans, Yale University, Boston University, United States Department of Veterans Affairs, VA Connecticut Healthcare System, First Pavlov State Medical University of St. Petersburg, St.Petersburg V.M.Bekhterev Psychoneurological Research Institute, Mbarara University of Science and Technology, South African Medical Research Council, University of Cape Town, Curtin University, University of Oklahoma Health Sciences Center, University at Buffalo, State University of New York, Johns Hopkins University, Johns Hopkins Medicine, San Francisco VA Medical Center, San Francisco VA Health Care System
Language: English
Subfield: Pathology and Forensic Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,390
Awards: URBAN ARCH (3/5) Uganda Cohort TB preventive therapy for HIV-infected alcohol users in Uganda: an evaluation of safety tolerability and adherence, G1559851360, G1805777700, G197529489, G231928015, G2358688911, G2364989932, G2378195067, G246404274, G2759654445, G2902682273, G3245976814, G3385694058, G3934014208, G4378641832, G4389003395, G513759803, G5175510404, Training in Research Program on Alcohol Use by Persons with our at Risk for HIV, G5861652225, G613578794, G679121021, G69522429, G6956489653, Phosphatidylethanol as an Alcohol Biomarker in Patients with Liver Disease, G710087273, G8142833747, URBAN ARCH (5/5) Boston Cohort - Alcohol and HIV-associated comorbidity and complications: Frailty, Functional impairment, Falls, and Fractures (the 4F study), Interventions to improve alcohol-related comorbidities along the gut-brain axis in persons with HIV infection
OpenAlex ID: W4403947061