Search resultsModerate Alcohol use is not Associated with Fibrosis Progression in HIV/HCV Co-Infected Women: A Prospective Cohort Study.
Background & Aims: Heavy alcohol use can lead to progressive liver damage, especially in individuals with chronic hepatitis C (HCV), however the impact of non-heavy use is not clear. We studied long-term effects of modest alcohol use on fibrosis progression in a large cohort of women co-infected with HIV/HCV.
Methods: Alcohol intake was ascertained every 6 months and use categorized as abstinent, light (1-3 drinks/week), moderate (4-7 drinks/week), heavy (>7 drinks/week) and very heavy (>14 drinks/week). Fibrosis progression was defined as the change in FIB-4 units per year using random-intercept-random-slope mixed modelling.
Results: Among 686 HIV/HCV co-infected women, 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. Median (IQR) FIB-4 at entry was similar between groups. On multivariable analysis, compared 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]. Very heavy drinking (>14 drinks/week) showed significant fibrosis acceleration [0.25 (0.01 to 0.49) FIB-4 units/year] compared to abstaining, while drinking 8-14 drinks per week showed minimal acceleration of fibrosis progression [0.04 (-0.19 to 0.28) FIB4 units/year].
Conclusions: Light/moderate alcohol use was not substantially associated with accelerated fibrosis progression, while drinking >14 drinks per week showed increased rates of fibrosis progression. Women with HIV/HCV infection should be counselled against heavy alcohol consumption, but complete abstinence may not be required to prevent accelerated liver fibrosis progression.