Ghosh Abhishek, Singh Geetesh K, Yadav Nidhi, Singh Pranshu, Kathiravan Sanjana
Drug Deaddiction and Treatment Centre, Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Department of Psychology, SCBS, Rashtriya Raksha University (An Institute of National Importance) Lavad, Gandhinagar, India.
Am J Drug Alcohol Abuse. 2023 Nov 2;49(6):766-786. doi: 10.1080/00952990.2023.2248647. Epub 2023 Dec 11.
One-third of people living with HIV (PLHIV) have alcohol misuse or alcohol use disorders which negatively affect course and outcome of HIV. The meta-analysis sought to evaluate the effectiveness of brief interventions (BI) on alcohol and HIV outcomes in PLHIV with alcohol misuse. We included clinical trials published between 1990 and September 2022 on adults with harmful/hazardous alcohol use; only randomized clinical trials (RCTs) were included in the meta-analysis. We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Clinical Trials.Gov, and the World Health Organization's International Clinical Trials Registry Platform databases. Cochrane's risk-of-bias assessment was used. Eighteen studies were included in the narrative synthesis, and a meta-analysis could be performed on 13 studies. Among the included RCTs, seven showed a low risk and two showed a high risk of bias; others showed some concerns. There was no evidence of publication bias. Compared to the control, BI significantly reduces the drinks per drinking day ( = 5, Hedge's g= -0.45, 95%CI = -0.58, -0.32) and the number of heavy drinking days ( = 4, Hedge'sg = -0.81, 95% CI= -0.94, -0.67) between 3-6 months post-intervention. BI also reduces the odds of mortality by 42% ( = 7, OR = 0.58, 95% CI = 0.34, 0.99) in 6-12 months. BI does not change the alcohol risk scores and transition to harmful alcohol use; it does not improve adherence to Anti-Retroviral Therapy and increase viral suppression. Policymakers must introduce and scale up integrated screening and brief intervention services within HIV clinics and primary care.
三分之一的艾滋病毒感染者（PLHIV）存在酒精滥用或酒精使用障碍，这会对艾滋病毒的病程和转归产生负面影响。这项荟萃分析旨在评估简短干预（BI）对存在酒精滥用的艾滋病毒感染者的酒精及艾滋病毒相关转归的有效性。我们纳入了1990年至2022年9月间发表的关于有害/危险饮酒成年人的临床试验；荟萃分析仅纳入随机临床试验（RCT）。我们检索了MEDLINE、EMBASE、Cochrane对照试验中央注册库、ClinicalTrials.Gov以及世界卫生组织国际临床试验注册平台数据库。采用Cochrane偏倚风险评估。18项研究纳入叙述性综述，13项研究可进行荟萃分析。在纳入的RCT中，7项显示低偏倚风险，2项显示高偏倚风险；其他研究显示存在一些问题。没有证据表明存在发表偏倚。与对照组相比，简短干预在干预后3至6个月显著减少了每日饮酒量（n = 5，Hedge's g = -0.45，95%CI = -0.58，-0.32）和重度饮酒天数（n = 4，Hedge's g = -0.81，95%CI = -0.94，-0.67）。简短干预在6至12个月时还将死亡几率降低了42%（n = 7，OR = 0.58，95%CI = 0.34，0.99）。简短干预不会改变酒精风险评分，也不会转变为有害饮酒；它不会提高对抗逆转录病毒治疗的依从性，也不会增加病毒抑制。政策制定者必须在艾滋病毒诊所和初级保健机构中引入并扩大综合筛查和简短干预服务。
