Hazardous drinking is associated with an elevated aspartate aminotransferase to platelet ratio index in an urban HIV‐infected clinical cohort

• Published in: HIV medicine 2009-03, Vol.10 (3), p.133-142
• Main Authors: Chaudhry, AA, Sulkowski, MS, Chander, G, Moore, RD
• Format: Article
• Language: English
• Subjects: Adult; alcohol; Alcohol-Related Disorders - blood; Alcohol-Related Disorders - complications; Alcohol-Related Disorders - enzymology; aspartate aminotransferase to platelet ratio index; Aspartate Aminotransferases - metabolism; Biomarkers - metabolism; Cross-Sectional Studies; Female; Hepatitis B - blood; Hepatitis B - complications; Hepatitis B - enzymology; Hepatitis C virus; Hepatitis C, Chronic - blood; Hepatitis C, Chronic - complications; Hepatitis C, Chronic - enzymology; HIV Infections - blood; HIV Infections - complications; HIV Infections - enzymology; Human immunodeficiency virus; Humans; Liver Cirrhosis, Alcoholic - blood; Liver Cirrhosis, Alcoholic - complications; Liver Cirrhosis, Alcoholic - enzymology; liver fibrosis; Logistic Models; Male; Platelet Count; Prognosis; Urban Health; viral hepatitis
• ISSN: 1464-2662; 1468-1293
• DOI: 10.1111/j.1468-1293.2008.00662.x

Objectives The aim of the study was to determine the relationship between alcohol consumption and liver fibrosis as assessed by aspartate aminotransferase to platelet ratio index (APRI) in HIV‐infected adults and to explore the relative contributions of alcohol and hepatitis C virus (HCV) to APRI among HIV/HCV‐coinfected adults. Methods We performed a cross‐sectional analysis of data from an observational clinical cohort. Alcohol consumption was categorized according to National Institute on Alcohol Abuse and Alcoholism guidelines. We defined significant liver disease as APRI>1.5, and used multinomial logistic regression to identify correlates of increased APRI. Results Among 1358 participants, 10.4% reported hazardous drinking. It was found that 11.6% had APRI>1.5, indicating liver fibrosis. Hazardous drinking was associated with increased APRI [adjusted relative risk ratio (RRR) 2.30; 95% confidence interval (CI) 1.26–4.17]. Other factors associated with increased APRI were male gender, viral hepatitis, and HIV transmission category of injecting drug use. Among coinfected individuals, 18.3% had APRI>1.5, and hazardous drinking was not associated with APRI. Among non‐HCV‐infected individuals, 5.3% had APRI>1.5 and hazardous drinking was associated with increased APRI (adjusted RRR 3.72; 95% CI 1.40–9.87). Conclusions Hazardous drinking is an important modifiable risk factor for liver fibrosis, particularly among non‐HCV‐infected patients. Clinicians and researchers must address alcohol use as the burden of liver disease increases among HIV‐positive individuals.