Long-term alcohol use patterns and HIV disease severity.

Area of Science:

• Infectious Diseases
• Public Health
• Addiction Medicine

Background:

• HIV-infected veterans represent a significant population with complex health needs.
• Understanding factors influencing HIV disease progression is crucial for effective management.
• Alcohol consumption is a common comorbidity that may impact HIV outcomes.

Purpose of the Study:

• To investigate the relationship between different alcohol use trajectories and HIV disease severity.
• To identify patterns of alcohol consumption and their association with morbidity and mortality in HIV-infected veterans.

Main Methods:

• A prospective cohort study of HIV-infected individuals within the Veterans Health Administration.
• Annual assessment of alcohol consumption using the AUDIT-C and HIV disease severity via the VACS index.
• Joint trajectory modeling to analyze the co-evolution of alcohol use and HIV disease severity.

Main Results:

• Four distinct alcohol consumption trajectories were identified: abstainers, lower risk, moderate risk, and higher risk drinkers.
• Alcohol use trajectories strongly correlated with phosphatidylethanol levels, a biomarker for alcohol consumption.
• Higher risk drinking patterns were significantly associated with more severe HIV disease (extreme VACS index group).

Conclusions:

• Persistent unhealthy alcohol use is associated with increased HIV disease severity among US veterans.
• These findings underscore the importance of addressing alcohol use in the management of HIV infection.
• Tailored interventions for alcohol use may improve health outcomes for HIV-infected populations.