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Association Between Excessive Alcohol Consumption When Starting Antiretroviral Therapy and Long-term Mortality in

Daniel Fuster, Cristina Moreno, Arantza Sanvisens

    Journal of Addiction Medicine
    |December 3, 2025
    PubMed

    Insights

    Excessive alcohol consumption (≥40 g/d) significantly increases mortality risk in people living with HIV (PWH). This study highlights the importance of addressing alcohol use in HIV care to improve patient outcomes and longevity.

    Area of Science:

    • Public Health
    • Epidemiology
    • HIV Medicine

    Background:

    • Alcohol consumption is common among people living with HIV (PWH).
    • Understanding the impact of alcohol on mortality in PWH is crucial for effective clinical management.
    • Previous studies have shown mixed results regarding alcohol's effect on HIV outcomes.

    Purpose of the Study:

    • To investigate the association between alcohol consumption levels and all-cause mortality in a cohort of HIV-positive individuals.
    • To quantify the risk of death associated with excessive alcohol intake in PWH.
    • To identify potential confounders influencing the alcohol-mortality relationship in this population.

    Main Methods:

    • A Spanish multicenter cohort study (CoRIS) including ART-naive PWH aged ≥18 years (2004-2022).
    • Mortality rates were calculated per 100 person-years (p-y).
    • Multivariable Cox models were used to estimate hazard ratios (HR) for mortality, adjusting for demographic, clinical, and behavioral factors.

    Main Results:

    • The study included 6087 PWH; 4.4% reported excessive alcohol consumption (≥40 g/d).
    • Over 31,171 p-y of follow-up, 240 participants died.
    • Excessive alcohol consumption was associated with a significantly increased risk of mortality (adjusted HR: 1.54; 95% CI: 1.06-3.42; P=0.02).

    Conclusions:

    • Excessive alcohol use is a significant risk factor for increased mortality among people living with HIV.
    • These findings underscore the need for interventions to reduce harmful alcohol consumption in PWH.
    • Addressing alcohol use may improve survival rates and long-term outcomes for individuals with HIV.
    Abstract

    Keywords:
    HIVSpainalcoholcohort studyinjecting drug usemortality

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