Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Department of Medicine, Boston Medical Center, and Boston University School of Medicine, Boston, Massachusetts 02118, USA.
J Stud Alcohol Drugs. 2013 Mar;74(2):266-70. doi: 10.15288/jsad.2013.74.266.
The purpose of this study was to examine the association between risky drinking amounts and serum aminotransferase levels in HIV-infected adults with and without hepatitis C virus (HCV) infection.
In a prospective cohort of HIV-infected adults with current or past alcohol problems, we assessed whether drinking risky amounts (as defined by the National Institute on Alcohol Abuse and Alcoholism) was associated with higher levels of serum aspartate aminotransferase [AST] and alanine aminotransferase [ALT]) over time, stratifying analyses by HCV status. Generalized linear mixed effects regression models were used to examine the association between risky drinking and natural log-transformed AST and ALT over time.
Among HIV/HCV-coinfected persons (n = 200), risky drinking was associated with a higher adjusted mean AST (62.2 vs. 51.4 U/L; adjusted ratio of means 1.2, 95% CI [1.07, 1.37], p = .003) and ALT (51.3 vs. 41.6 U/L; adjusted ratio of means 1.2, 95% CI [1.07, 1.42], p = .004) compared with non-risky drinking. In contrast, among HIV-infected adults without HCV infection (n = 197), there were no significant differences between those who did and did not drink risky amounts in AST (34.7 vs. 33.3 U/L; adjusted ratio of means = 1.0, 95% CI [0.95, 1.14], p = .36) or ALT (29.1 vs. 28.7 U/L; adjusted ratio of means = 1.0, 95% CI [0.91, 1.13], p = .78).
Among HIV-infected adults with HCV, those who drink risky amounts have higher serum aminotransferase levels than those who do not drink risky amounts. These results suggest that drinking risky amounts may be particularly harmful in HIV/HCV-coinfected adults and supports recommendations that providers pay special attention to drinking in this population.
本研究旨在探讨感染 HIV 的成年人中，有无丙型肝炎病毒（HCV）感染，饮酒量达到危险值与血清氨基转移酶水平之间的相关性。
在有当前或既往酒精问题的 HIV 感染成年人的前瞻性队列中，我们评估了在 HCV 感染状态分层的情况下，饮酒量达到危险值（由国家酒精滥用与酒精中毒研究所定义）是否与血清天冬氨酸氨基转移酶[AST]和丙氨酸氨基转移酶[ALT]水平的升高有关。采用广义线性混合效应回归模型，检验了危险饮酒与自然对数转换后的 AST 和 ALT 随时间的关系。
在 HIV/HCV 合并感染人群（n = 200）中，与非危险饮酒者相比，危险饮酒者的 AST（62.2 比 51.4 U/L；调整后均数比 [95%CI] 1.2[1.07, 1.37]，p =.003）和 ALT（51.3 比 41.6 U/L；调整后均数比 1.2[1.07, 1.42]，p =.004）的调整平均水平更高。相比之下，在无 HCV 感染的 HIV 感染成年人（n = 197）中，饮酒量达到危险值与未达到危险值者的 AST（34.7 比 33.3 U/L；调整后均数比 1.0[0.95, 1.14]，p =.36）或 ALT（29.1 比 28.7 U/L；调整后均数比 1.0[0.91, 1.13]，p =.78）之间均无显著差异。
在 HIV 合并 HCV 感染的成年人中，饮酒量达到危险值者的血清氨基转移酶水平高于未饮酒量达到危险值者。这些结果表明，饮酒量达到危险值可能对 HIV/HCV 合并感染的成年人特别有害，并支持提供者在该人群中特别关注饮酒问题的建议。
