title: Self-reported alcohol abuse in HIV-HCV co-infected patients: a better predictor of HIV virological rebound than physician's perceptions (HEPAVIH ARNS CO13 cohort).
abstract: OBJECTIVE
  Studying alcohol abuse impact, as measured by physicians' perceptions and patients' self-reports, on HIV virological rebound among patients chronically co-infected with HIV and hepatitis C virus (HCV).
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  Seventeen French hospitals.
  
  
  METHODS
  Five hundred and twelve patients receiving antiretroviral therapy (ART) with an undetectable initial HIV viral load and at least two viral load measures during follow-up.
  
  
  METHODS
  Medical records and self-administered questionnaires. HIV virological rebound defined as HIV viral load above the limit of detection of the given hospital's laboratory test. Alcohol abuse defined as reporting to have drunk regularly at least 4 (for men) or 3 (for women) alcohol units per day during the previous 6 months. Correlates of time to HIV virological rebound identified using Cox proportional hazards models.
  
  
  RESULTS
  At enrolment, 9% of patients reported alcohol abuse. Physicians considered 14.8% of all participants as alcohol abusers. Self-reported alcohol abuse was associated independently with HIV virological rebound [hazard ratio (95% confidence interval): 2.04 (1.13-3.67); P = 0.02], after adjustment for CD4 count, time since ART initiation and hospital HIV caseload. No significant relationship was observed between physician-reported alcohol abuse and virological rebound (P = 0.87).
  
  
  CONCLUSIONS
  In France, the assessment of alcohol abuse in patients co-infected with HIV and hepatitis C virus should be based on patients' self-reports, rather than physicians' perceptions. Baseline screening of self-reported alcohol abuse may help identify co-infected patients at risk of subsequent HIV virological rebound.
authors: INSERM, UMR912 (SESSTIM), Marseille, France. fabienne.marcellin@inserm.fr
authors: Fabienne
authors: F
authors: Marcellin
authors: Caroline
authors: C
authors: Lions
authors: Maria
authors: M
authors: Winnock
authors: Dominique
authors: D
authors: Salmon
authors: Jacques
authors: J
authors: Durant
authors: Bruno
authors: B
authors: Spire
authors: Marion
authors: M
authors: Mora
authors: Marc-Arthur
authors: MA
authors: Loko
authors: François
authors: F
authors: Dabis
authors: Stéphanie
authors: S
authors: Dominguez
authors: Perrine
authors: P
authors: Roux
authors: Maria Patrizia
authors: MP
authors: Carrieri
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000821:virology*; D060085:Coinfection / Q000821:virology*; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000821:virology*; D016174:Hepacivirus; D006526:Hepatitis C / Q000821:virology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D057566:Self Report; D019562:Viral Load