Kelly EM, et al. – In a large cohort of women co–infected with HIV/hepatitis C (HCV), long–term effects of modest alcohol use on fibrosis progression was investigated. As per observations, light/moderate alcohol use seemed not substantially associated with accelerated fibrosis progression, while drinking >14 drinks per week showed increased rates of fibrosis progression. Researchers recommend counseling women with HIV/HCV infection against heavy alcohol consumption, however, complete abstinence would not be required to prevent accelerated liver fibrosis progression.

Methods

• Researchers determined alcohol intake every 6 months and categorized alcohol use as abstinent, light (1–3 drinks/week), moderate (4–7 drinks/week), heavy (>7 drinks/week) and very heavy (>14 drinks/week).
• They defined fibrosis progression as the change in FIB-4 units per year using random-intercept-random-slope mixed modelling.

Results

• 686 HIV/HCV co-infected women were identified; 46.0% reported no alcohol use; 26.8% reported light use; 7.1% moderate use; and 19.7% heavy use [6.7% 8–14 drinks/week and 13.0% >14 drinks/week] at cohort entry.
• The groups were similar regarding median (IQR) FIB-4 at entry.
• Multivariable analysis suggested that in comparison to abstainers, light and moderate alcohol use was not associated with fibrosis progression [0.004 (95%CI -0.11 to 0.12) and 0.006 (-0.18 to 0.19) FIB-4 units/year), respectively].
• Marked fibrosis acceleration was observed with very heavy drinking (>14 drinks/week) [0.25 (0.01 to 0.49) FIB-4 units/year] compared to abstaining, while drinking 8–14 drinks per week indicated minimal acceleration of fibrosis progression [0.04 (-0.19 to 0.28) FIB4 units/year].