Alcohol-related liver disease more common among those with HIV and Hepatitis C

Advanced liver disease caused by alcohol consumption was more prevalent among people infected with HIV and the hepatitis C (HCV) virus, a new study has found. The study is published online in the journal Clinical Infectious Diseases.

The research team studied participants in the Veterans Aging Cohort Study who reported alcohol consumption. Some were infected with HIV, others with HCV, still others with both viruses, and a large number were not infected with either.

Among those with HIV and/or HCV, advanced hepatic (liver) fibrosis increased along with the quantity of alcohol consumed. Disease levels were significantly lower among the uninfected, even as alcohol consumption rose.

The strongest alcohol-related association with advanced hepatic fibrosis was observed among patients infected with both HIV and HCV. 

“Our study shows that not only excessive drinking, but even moderate drinking is associated with an enhanced risk of advanced liver fibrosis and cirrhosis,” said first author Joseph K. Lim, M.D., of Yale School of Medicine and the VA Connecticut Healthcare System. “The step-wise increases in prevalence of advanced liver disease with progressive levels of alcohol consumption further support clinical recommendations to curb or eliminate alcohol consumption among patients with HCV and/or HIV infection,” he added. 

Lim says future studies should aim to clarify longitudinal changes in the risk of advanced liver disease with varying levels of alcohol consumption, and address the question of whether there is a safe level of alcohol exposure for infected patients.

Other authors are Janet Tate, Joseph Goulet, and Amy Justice of Yale and the VA Connecticut Healthcare System; David Fiellin of Yale; Joseph Conigliaro of Hofstra School of Medicine; Kendall Bryant of the National Institute on Alcohol Abuse and Alcoholism; Adam Gordon of the University of Pittsburgh; Cynthia Gibert of the Washington, D.C. VA Medical Center and George Washington University; David Rimland of the Atlanta VA Medical Center and Emory University; Matthew Goetz of the VA Greater Los Angeles Healthcare System and University of California-Los Angeles; Marina Klein of McGill University; and senior author Vincent Lo Re of the Perelman School of Medicine at the University of Pennsylvania, and the Philadelphia VA Medical Center.

This study was supported by grants from the National Institute on Alcohol Abuse and Alcoholism (U01 AA13566 and R21 AA015894), and the National Institute of Allergy and Infectious Diseases (K01 AI070001).

DOI: 10.1093/cid/ciu097

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