Association of Alcohol Consumption and HIV Surrogate Markers in Participants of the Swiss HIV Cohort Study
Association of Alcohol Consumption and HIV Surrogate Markers in Participants of the Swiss HIV Cohort Study
复制标题
DOI：
10.1097/qai.0b013e3182a61ea9
复制
发表时间：
2013-12-15
影响因子：
3.6
通讯作者：
Fehr, Jan
中科院分区：
文献类型：
--
作者：
Conen, Anna;Wang, Qing;Fehr, Jan
背景：饮酒可能影响HIV感染和/或抗逆转录病毒治疗（ART）的过程。作者调查了自我报告的饮酒量和治疗和未治疗个体的HIV替代标志物之间的关联。设计：前瞻性队列研究。方法：在7年的时间里，作者分析了瑞士HIV队列研究中的2组个体：（1）未接受过抗逆转录病毒疗法的个体，以及（2）开始第一次抗逆转录病毒疗法的个体。使用时间依赖性考克斯比例风险模型来评估饮酒、病毒学失败和ART中断之间的关联。对于这两组，对数转换的CD 4细胞计数的轨迹进行了分析，使用线性混合模型与重复measures.Results：作者包括2982个人开始第一次ART和2085 ART初治。在首次接受ART的个体中，241人（8%）出现病毒学失败。饮酒与病毒学失败无关。在449例（15%）个体中观察到ART中断，与无/轻度健康风险饮酒者相比，严重饮酒者更普遍[风险比：2.24，95%置信区间：1.42至3.52]。即使在调整了不依从性后，这种关联仍然很显著。作者没有发现两组中饮酒与CD 4细胞计数随时间变化之间存在关联。结论：在ART启动组和ART初治组中，饮酒对病毒学失败或CD 4细胞计数均无影响。重度饮酒者更有可能中断抗逆转录病毒治疗。应特别在报告高度饮酒的个体中实施继续抗逆转录病毒治疗的努力消费
Background: Alcohol consumption may affect the course of HIV infection and/or antiretroviral therapy (ART). The authors investigated the association between self-reported alcohol consumption and HIV surrogate markers in both treated and untreated individuals.Design: Prospective cohort study.Methods: Over a 7-year period, the authors analyzed 2 groups of individuals in the Swiss HIV Cohort Study: (1) ART-naive individuals remaining off ART and (2) individuals initiating first ART. For individuals initiating first ART, time-dependent Cox proportional hazards models were used to assess the association between alcohol consumption, virological failure, and ART interruption. For both groups, trajectories of log-transformed CD4 cell counts were analyzed using linear mixed models with repeated measures.Results: The authors included 2982 individuals initiating first ART and 2085 ART naives. In individuals initiating first ART, 241 (8%) experienced virological failure. Alcohol consumption was not associated with virological failure. ART interruption was noted in 449 (15%) individuals and was more prevalent in severe compared with none/light health risk drinkers [hazard ratio: 2.24, 95% confidence interval: 1.42 to 3.52]. The association remained significant even after adjusting for nonadherence. The authors did not find an association between alcohol consumption and change in CD4 cell count over time in either group.Conclusions: No effect of alcohol consumption on either virological failure or CD4 cell count in both groups of ART-initiating and ART-naive individuals was found. However, severe drinkers were more likely to interrupt ART. Efforts on ART continuation should be especially implemented in individuals reporting high alcohol consumption.