TY - JOUR
T1 - Contribution of alcohol use in HIV/hepatitis C virus co-infection to all-cause and cause-specific mortality
T2 - A collaboration of cohort studies
AU - Trickey, Adam
AU - Ingle, Suzanne M.
AU - Boyd, Anders
AU - Gill, M. John
AU - Grabar, Sophie
AU - Jarrin, Inma
AU - Obel, Niels
AU - Touloumi, Giota
AU - Zangerle, Robert
AU - Rauch, Andri
AU - Rentsch, Christopher T.
AU - Satre, Derek D.
AU - Silverberg, Michael J.
AU - Bonnet, Fabrice
AU - Guest, Jodie
AU - Burkholder, Greer
AU - Crane, Heidi
AU - Teira, Ramon
AU - Berenguer, Juan
AU - Wyen, Christoph
AU - Abgrall, Sophie
AU - Hessamfar, Mojgan
AU - Reiss, Peter
AU - d’Arminio Monforte, Antonella
AU - McGinnis, Kathleen A.
AU - Sterne, Jonathan A. C.
AU - The Antiretroviral Therapy Cohort Collaboration
AU - Wittkop, Linda
N1 - Funding Information: We would like to thank all patients and the clinical teams associated with the participating cohort studies. Publisher Copyright: © 2023 The Authors. Journal of Viral Hepatitis published by John Wiley & Sons Ltd.
PY - 2023/9
Y1 - 2023/9
N2 - Among persons with HIV (PWH), higher alcohol use and having hepatitis C virus (HCV) are separately associated with increased morbidity and mortality. We investigated whether the association between alcohol use and mortality among PWH is modified by HCV. Data were combined from European and North American cohorts of adult PWH who started antiretroviral therapy (ART). Self-reported alcohol use data, collected in diverse ways between cohorts, were converted to grams/day. Eligible PWH started ART during 2001–2017 and were followed from ART initiation for mortality. Interactions between the associations of baseline alcohol use (0, 0.1–20.0, >20.0 g/day) and HCV status were assessed using multivariable Cox models. Of 58,769 PWH, 29,711 (51%), 23,974 (41%) and 5084 (9%) self-reported alcohol use of 0 g/day, 0.1–20.0 g/day, and > 20.0 g/day, respectively, and 4799 (8%) had HCV at baseline. There were 844 deaths in 37,729 person-years and 2755 deaths in 443,121 person-years among those with and without HCV, respectively. Among PWH without HCV, adjusted hazard ratios (aHRs) for mortality were 1.18 (95% CI: 1.08–1.29) for 0.0 g/day and 1.84 (1.62–2.09) for >20.0 g/day compared with 0.1–20.0 g/day. This J-shaped pattern was absent among those with HCV: aHRs were 1.00 (0.86–1.17) for 0.0 g/day and 1.64 (1.33–2.02) for >20.0 g/day compared with 0.1–20.0 g/day (interaction p <.001). Among PWH without HCV, mortality was higher in both non-drinkers and heavy drinkers compared with moderate alcohol drinkers. Among those with HCV, mortality was higher in heavy drinkers but not non-drinkers, potentially due to differing reasons for not drinking (e.g. illness) between those with and without HCV.
AB - Among persons with HIV (PWH), higher alcohol use and having hepatitis C virus (HCV) are separately associated with increased morbidity and mortality. We investigated whether the association between alcohol use and mortality among PWH is modified by HCV. Data were combined from European and North American cohorts of adult PWH who started antiretroviral therapy (ART). Self-reported alcohol use data, collected in diverse ways between cohorts, were converted to grams/day. Eligible PWH started ART during 2001–2017 and were followed from ART initiation for mortality. Interactions between the associations of baseline alcohol use (0, 0.1–20.0, >20.0 g/day) and HCV status were assessed using multivariable Cox models. Of 58,769 PWH, 29,711 (51%), 23,974 (41%) and 5084 (9%) self-reported alcohol use of 0 g/day, 0.1–20.0 g/day, and > 20.0 g/day, respectively, and 4799 (8%) had HCV at baseline. There were 844 deaths in 37,729 person-years and 2755 deaths in 443,121 person-years among those with and without HCV, respectively. Among PWH without HCV, adjusted hazard ratios (aHRs) for mortality were 1.18 (95% CI: 1.08–1.29) for 0.0 g/day and 1.84 (1.62–2.09) for >20.0 g/day compared with 0.1–20.0 g/day. This J-shaped pattern was absent among those with HCV: aHRs were 1.00 (0.86–1.17) for 0.0 g/day and 1.64 (1.33–2.02) for >20.0 g/day compared with 0.1–20.0 g/day (interaction p <.001). Among PWH without HCV, mortality was higher in both non-drinkers and heavy drinkers compared with moderate alcohol drinkers. Among those with HCV, mortality was higher in heavy drinkers but not non-drinkers, potentially due to differing reasons for not drinking (e.g. illness) between those with and without HCV.
KW - HIV
KW - alcohol
KW - cause-specific
KW - cohort
KW - hepatitis C virus
KW - mortality
UR - http://www.scopus.com/inward/record.url?scp=85163008850&partnerID=8YFLogxK
U2 - https://doi.org/10.1111/jvh.13863
DO - https://doi.org/10.1111/jvh.13863
M3 - Article
C2 - 37338017
SN - 1352-0504
VL - 30
SP - 775
EP - 786
JO - Journal of viral hepatitis
JF - Journal of viral hepatitis
IS - 9
ER -