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Risk of mortality and physiologic injury evident with lower alcohol exposure among HIV infected compared with

Amy C Justice1, Kathleen A McGinnis2, Janet P Tate1

  • 1Veterans Aging Cohort Study Coordinating Center, West Haven VA Healthcare System, 950 Campbell Ave, West Haven, CT 06516, USA; Department of Internal Medicine, and the Center for Interdisciplinary Research on AIDS (CIRA), Yale School of Medicine, Yale University 367 Cedar Street, New Haven, CT 06510, USA.

Drug and Alcohol Dependence
|February 11, 2016
PubMed

Insights

HIV-infected individuals face higher mortality and injury risks from alcohol use, even with treatment. Lower alcohol consumption limits are recommended for those with HIV.

Area of Science:

  • Medical Research
  • Public Health
  • Infectious Diseases

Background:

  • Individuals with Human Immunodeficiency Virus (HIV) may be more vulnerable to alcohol-related health issues than those without HIV.
  • Antiretroviral therapy (ART) has improved outcomes for HIV-positive individuals, but co-occurring conditions like alcohol use disorders remain a concern.

Purpose of the Study:

  • To investigate the differential impact of alcohol consumption on mortality and physiological injury in HIV-positive versus HIV-uninfected individuals.
  • To determine specific alcohol consumption thresholds associated with adverse outcomes in both HIV-positive and HIV-uninfected populations.

Main Methods:

  • Analysis of data from the Veterans Aging Cohort Study (VACS) including HIV-positive and HIV-uninfected participants.
  • Utilized Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) scores and Cox proportional hazards models for mortality analysis.
  • Employed linear regression models to assess physiological injury using VACS Index Scores, adjusting for covariates like age, race, smoking, and hepatitis C infection.

Main Results:

  • The study included 18,145 HIV-positive and 42,228 HIV-uninfected individuals.
  • Lower alcohol consumption levels (AUDIT-C score ≥4 or ≥30 drinks/month) were associated with increased mortality risk in HIV-positive individuals compared to HIV-uninfected individuals (AUDIT-C score ≥5 or ≥70 drinks/month).
  • Physiological injury was linked to lower AUDIT-C scores in HIV-positive individuals (scores 5-7) versus HIV-uninfected individuals (score ≥8).

Conclusions:

  • HIV-positive individuals experience greater mortality and physiological harm from alcohol use, even when on ART, compared to their HIV-uninfected counterparts.
  • Recommended alcohol consumption limits should be lower for HIV-positive individuals to mitigate health risks.
  • These findings underscore the importance of tailored alcohol use guidelines for vulnerable populations in HIV care.
Abstract

Keywords:
AUDIT-CAlcoholHIVMorbidityMortalityVACS IndexVeteran

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