title: Hazardous drinking is associated with an elevated aspartate aminotransferase to platelet ratio index in an urban HIV-infected clinical cohort.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA. amina.chaudhry@jhu.edu
authors.forename: A A
authors.initials: AA
authors.lastname: Chaudhry
authors.forename: M S
authors.initials: MS
authors.lastname: Sulkowski
authors.forename: G
authors.initials: G
authors.lastname: Chander
authors.forename: R D
authors.initials: RD
authors.lastname: Moore
mesh_terms: D000328:Adult; D019973:Alcohol-Related Disorders / Q000097:blood / Q000150:complications / Q000201:enzymology*; D001219:Aspartate Aminotransferases / Q000378:metabolism*; D015415:Biomarkers / Q000378:metabolism; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000150:complications / Q000201:enzymology*; D006509:Hepatitis B / Q000097:blood / Q000150:complications / Q000201:enzymology*; D019698:Hepatitis C, Chronic / Q000097:blood / Q000150:complications / Q000201:enzymology; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000097:blood / Q000150:complications / Q000201:enzymology*; D016015:Logistic Models; D008297:Male; D010976:Platelet Count; D011379:Prognosis; D014504:Urban Health
chemical_list: D015415:Biomarkers; D001219:Aspartate Aminotransferases