Kelso-Chichetto Natalie E, Plankey Michael, Abraham Alison G, Ennis Nicole, Chen Xinguang, Bolan Robert, Cook Robert L
a Department of Epidemiology , Colleges of Public Health and Health Professions and Medicine, University of Florida , Gainesville , FL , USA.
b Department of Medicine , Georgetown University Medical Center , Washington , DC , USA.
Am J Drug Alcohol Abuse. 2018;44(1):85-94. doi: 10.1080/00952990.2017.1335317. Epub 2017 Jun 16.
Alcohol use is common among persons living with HIV (PLWH). It is unclear how alcohol consumption changes over time and if these changes are associated with clinical profiles.
We aimed to describe the association between longitudinal patterns of alcohol consumption and the clinical profiles of PLWH.
Data from the Women's Interagency HIV Study (n = 1123 women) and Multicenter AIDS Cohort Study (n = 597 men) from 2004 to 2013 were utilized. Group-based trajectory models were used to assess alcohol consumption patterns across 10 years. Generalized estimating equations were used to identify associations between clinical factors and alcohol consumption. All analyses were stratified by sex.
Four trajectories of alcohol use were identified in women and men (women: abstinent 38%, low: 25%, moderate: 30%, heavy: 7%; men: abstinent 16%, low: 69%, moderate: 9%, heavy: 5%). The Framingham Risk Score (women: adjusted odds ratio [AOR] 1.07, 95% confidence interval [CI] 1.04-1.09), years on ART (women: AOR 1.02, CI 1.00-1.05; men: AOR 1.05, CI 1.01-1.09), suboptimal ART adherence (men: AOR 1.23, CI 1.07-1.42), and unsuppressed viral load (women: AOR 1.82, CI 1.56-2.13; men: AOR 1.36, CI 1.17-1.58) were associated with increased odds for moderate drinking. The Framingham Risk Score (women: AOR 1.10, CI 1.07-1.14; men: AOR 1.12, CI 1.06-1.20), suboptimal adherence (women: AOR 1.25, CI 1.04-1.51), and unsuppressed viral load (women: AOR 1.78, CI 1.42-2.24) were associated with increased odds for heavy drinking.
Clinicians should consider screening patients for alcohol consumption, particularly if patients have comorbid medical conditions, suboptimal antiretroviral adherence, and/or detectable viral load.
酒精使用在艾滋病毒感染者(PLWH)中很常见。目前尚不清楚酒精消费如何随时间变化,以及这些变化是否与临床特征相关。
我们旨在描述酒精消费的纵向模式与艾滋病毒感染者临床特征之间的关联。
利用2004年至2013年妇女机构间艾滋病毒研究(n = 1123名女性)和多中心艾滋病队列研究(n = 597名男性)的数据。基于组的轨迹模型用于评估10年间的酒精消费模式。广义估计方程用于确定临床因素与酒精消费之间的关联。所有分析均按性别分层。
在女性和男性中确定了四种酒精使用轨迹(女性:戒酒者38%,低饮酒者:25%,中度饮酒者:30%,重度饮酒者:7%;男性:戒酒者16%,低饮酒者:69%,中度饮酒者:9%,重度饮酒者:5%)。弗雷明汉风险评分(女性:调整优势比[AOR]1.07,95%置信区间[CI]1.04 - 1.09)、接受抗逆转录病毒治疗的年限(女性:AOR 1.02,CI 1.00 - 1.05;男性:AOR 1.05,CI 1.01 - 1.09)、抗逆转录病毒治疗依从性欠佳(男性:AOR 1.23,CI 1.07 - 1.42)以及病毒载量未得到抑制(女性:AOR 1.82,CI 1.56 - 2.13;男性:AOR 1.36,CI 1.17 - 1.58)与中度饮酒几率增加相关。弗雷明汉风险评分(女性:AOR 1.10,CI 1.07 - 1.14;男性:AOR 1.12,CI 1.06 - 1.20)、依从性欠佳(女性:AOR 1.25,CI 1.04 - 1.51)以及病毒载量未得到抑制(女性:AOR 1.78,CI 1.42 - 2.24)与重度饮酒几率增加相关。
临床医生应考虑对患者进行酒精消费筛查,特别是当患者患有合并症、抗逆转录病毒治疗依从性欠佳和/或病毒载量可检测到时。