The Role of Current and Historical Alcohol Use in Hepatic Fibrosis Among HIV-Infected Individuals

H. Nina Kim, Heidi M. Crane, Carla V. Rodriguez, Stephen Van Rompaey, Kenneth H. Mayer, Katerina Christopoulos, Sonia Napravnik, Geetanjali Chander, Heidi Hutton, Mary E. McCaul, Edward R. Cachay, Michael J. Mugavero, Richard Moore, Elvin Geng, Joseph J. Eron, Michael S. Saag, Joseph O. Merrill, Mari M. Kitahata

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


We examined risk factors for advanced hepatic fibrosis [fibrosis-4 (FIB)-4 >3.25] including both current alcohol use and a diagnosis of alcohol use disorder among HIV-infected patients. Of the 12,849 patients in our study, 2133 (17%) reported current hazardous drinking by AUDIT-C, 2321 (18%) had a diagnosis of alcohol use disorder, 2376 (18%) were co-infected with chronic hepatitis C virus (HCV); 596 (5%) had high FIB-4 scores >3.25 as did 364 (15%) of HIV/HCV coinfected patients. In multivariable analysis, HCV (adjusted odds ratio (aOR) 6.3, 95% confidence interval (CI) 5.2–7.5), chronic hepatitis B (aOR 2.0, 95% CI 1.5–2.8), diabetes (aOR 2.3, 95% CI 1.8–2.9), current CD4 <200 cells/mm3 (aOR 5.4, 95% CI 4.2–6.9) and HIV RNA >500 copies/mL (aOR 1.3, 95% CI 1.0–1.6) were significantly associated with advanced fibrosis. A diagnosis of an alcohol use disorder (aOR 1.9, 95% CI 1.6–2.3) rather than report of current hazardous alcohol use was associated with high FIB-4. However, among HIV/HCV coinfected patients, both current hazardous drinkers (aOR 1.6, 95% CI 1.1–2.4) and current non-drinkers (aOR 1.6, 95% CI 1.2–2.0) were more likely than non-hazardous drinkers to have high FIB-4, with the latter potentially reflecting the impact of sick abstainers. These findings highlight the importance of using a longitudinal measure of alcohol exposure when evaluating the impact of alcohol on liver disease and associated outcomes.

Original languageEnglish (US)
Pages (from-to)1878-1884
Number of pages7
JournalAIDS and behavior
Issue number7
StatePublished - Jul 1 2017


  • Alcohol
  • HIV
  • Liver fibrosis

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases


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