ICAP at Columbia University, Mailman School of Public Health, Columbia University, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
ICAP at Columbia University, Addis Ababa, Ethiopia.
Drug Alcohol Depend. 2019 Nov 1;204:107465. doi: 10.1016/j.drugalcdep.2019.04.036. Epub 2019 Aug 30.
Hepatotoxicity, an adverse effect of isoniazid preventative therapy (IPT), is exacerbated by alcohol consumption. Although the WHO recommends IPT for people living with HIV (PLHIV), it is contraindicated in regular alcohol users. The objective of this study was to identify the prevalence and determinants of alcohol use among PLHIV initiating IPT in Ethiopia.
Baseline data (July 2013-May 2015) from 316 participants in the Enhance Initiation and Retention in IPT Care for HIV (ENRICH) study were used to assess the prevalence of alcohol use. Multinomial logistic regression was used to identify determinants of non-hazardous and hazardous alcohol use, compared to no alcohol use.
Overall, 41.8% of participants reported alcohol use, of which 45.5% reported hazardous use. Compared to non-alcohol users, hazardous users were younger (adjusted odds ratio [AOR]: 1.06; 95% confidence interval [95% CI]: 1.02, 1.11), more likely to be male (AOR: 6.40; 95% CI: 3.17, 12.93), Orthodox (AOR: 3.96; 95% CI: 1.74, 9.00), have larger support networks (AOR: 3.82; 95% CI: 1.61, 9.06), and report greater amount (AOR: 14.80; 95% CI: 5.76, 38.02) and frequency (AOR: 5.91; 95% CI: 2.75, 12.67) of khat use.
Alcohol use was prevalent in this population, and current WHO guidelines would exclude a substantial proportion of the population from receiving IPT. PLHIV in this region would benefit from routine screening for alcohol and khat use, and from substance use education and counseling while receiving IPT until it can be determined whether alcohol users can safely receive IPT.
异烟肼预防性治疗（IPT）的不良反应之一是肝毒性，而饮酒会加重这种毒性。尽管世界卫生组织（WHO）建议为艾滋病毒感染者（PLHIV）提供 IPT，但它不适合经常饮酒的人。本研究的目的是确定在开始接受 IPT 的埃塞俄比亚 PLHIV 中饮酒的流行情况及其决定因素。
使用增强 IPT 护理中 HIV 感染者起始和维持治疗（ENRICH）研究的 316 名参与者的基线数据（2013 年 7 月至 2015 年 5 月），评估饮酒的流行情况。使用多变量逻辑回归，与不饮酒者相比，确定非危险和危险饮酒的决定因素。
总体而言，41.8%的参与者报告饮酒，其中 45.5%报告危险饮酒。与非饮酒者相比，危险饮酒者更年轻（调整后的优势比[OR]：1.06；95%置信区间[95%CI]：1.02，1.11），更有可能是男性（OR：6.40；95%CI：3.17，12.93），东正教（OR：3.96；95%CI：1.74，9.00），拥有更大的支持网络（OR：3.82；95%CI：1.61，9.06），并报告更多的量（OR：14.80；95%CI：5.76，38.02）和频率（OR：5.91；95%CI：2.75，12.67）的恰特草使用。
在该人群中，饮酒很普遍，目前的 WHO 指南将排除相当一部分人群接受 IPT。该地区的 PLHIV 将受益于常规筛查酒精和恰特草使用情况，以及在接受 IPT 期间接受药物使用教育和咨询，直到确定饮酒者是否可以安全接受 IPT。
