HIV/HCV Co-Infected Patients Have No Safe Level of Alcohol Use

By Annette M. Boyle

PHILADELPHIA – Otherwise “non-hazardous” levels of drinking pose a real danger for patients co-infected with human immunodeficiency virus (HIV) and hepatitis C virus. Drinking, even moderately, dramatically increases the risk of liver fibrosis, according to a new study.

“Our research suggests that there may be no safe levels of alcohol consumption for co-infected patients,” said Vincent Lo Re III, MD, an infectious disease physician at the Philadelphia VAMC and assistant professor of medicine and epidemiology in the division of infectious disease at the University of Pennsylvania’s Perelman School of Medicine.

Between 20% and 30% of HIV patients also have HCV.

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Lo Re was one of the researchers in a cross-sectional study among participants in the Veterans Aging Cohort Study who received care at one of eight VAMCs around the country and reported any current alcohol consumption at enrollment. Of those, 701 were HIV/HCV co-infected, 1,410 had only HIV, 296 had only HCV and 1,158 had neither virus. The researchers analyzed reported alcohol use and advanced hepatic fibrosis. The results were recently published in the journal Clinical Infectious Diseases.1

Researchers classified each participant into one of three mutually exclusive categories: an alcohol-related diagnosis (854 or 24%), hazardous or binge drinking (1,232 or 34.6%) and nonhazardous drinking (1,479 or 41.5%). Classification was based on clinical records and the results of the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) questionnaire, which asks about frequency of alcohol use, quantity of alcohol typically consumed and consumption of six or more drinks on any one occasion in the previous 12 months. Patients were considered to have advanced liver fibrosis if their fibrosis 4 (FIB-4) score exceeded 3.25.

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