Effect of alcohol consumption on all-cause and liver-related mortality among HIV-infected individuals.
The aim of the study was to examine the association between levels of past and current alcohol consumption and all-cause and liver-related mortality among people living with HIV (PLWH).



A prospective cohort study of 1855 PLWH in Baltimore, MD was carried out from 2000 to 2013. We ascertained alcohol use by (1) self-report (SR) through a computer-assisted self interview, and (2) medical record abstraction of provider-documented (PD) alcohol use. SR alcohol consumption was categorized as heavy (men: > 4 drinks/day or > 14 drinks/week; women: > 3 drinks/day or > 7 drinks/week), moderate (any alcohol consumption less than heavy), and none. We calculated the cumulative incidence of liver-related mortality and fitted adjusted cause-specific regression models to account for competing risks.



All-cause and liver-related mortality rates (MRs) were 43.0 and 7.2 per 1000 person-years (PY), respectively. All-cause mortality was highest among SR nondrinkers with PD recent (< 6 months) heavy drinking (MR = 85.4 deaths/1000 PY) and lowest among SR moderate drinkers with no PD history of heavy drinking (MR = 23.0 deaths/1000 PY). Compared with SR moderate drinkers with no PD history of heavy drinking, SR nondrinkers and moderate drinkers with PD recent heavy drinking had higher liver-related mortality [hazard ratio (HR) = 7.28 and 3.52, respectively]. However, SR nondrinkers and moderate drinkers with a PD drinking history of > 6 months ago showed similar rates of liver-related mortality (HR = 1.06 and 2.00, respectively).



Any heavy alcohol consumption was associated with all-cause mortality among HIV-infected individuals, while only recent heavy consumption was associated with liver-related mortality. Because mortality risk among nondrinkers varies substantially by drinking history, current consumption alone is insufficient to assess risk.
Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
C E
CE
Canan
Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.|Johns Hopkins School of Medicine, Baltimore, MD, USA.
B
B
Lau
Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.|Johns Hopkins School of Medicine, Baltimore, MD, USA.
M E
ME
McCaul
Johns Hopkins School of Medicine, Baltimore, MD, USA.
J
J
Keruly
Johns Hopkins School of Medicine, Baltimore, MD, USA.
R D
RD
Moore
Johns Hopkins School of Medicine, Baltimore, MD, USA.
G
G
Chander
D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects*; D015142:Baltimore / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D015994:Incidence; D008107:Liver Diseases / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016019:Survival Analysis

HIV
; alcohol consumption; all-cause mortality; liver-related mortality
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