Sex Differences, Cocaine Use, and Liver Fibrosis Among African Americans in the Miami Adult Studies on HIV Cohort
Sex Differences, Cocaine Use, and Liver Fibrosis Among African Americans in the Miami Adult Studies on HIV Cohort
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DOI：
10.1089/jwh.2019.7954
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发表时间：
2020-01-31
影响因子：
3.5
通讯作者：
Baum, Marianna K.
中科院分区：
文献类型：
--
作者：
Zarini, Gustavo;Sales Martinez, Sabrina;Baum, Marianna K.
背景：艾滋病毒感染不成比例地影响非洲裔美国人。肝病是这一人群中非艾滋病毒发病率和死亡率的主要原因。药物滥用加速艾滋病毒疾病，并可能促进肝脏疾病的进展。本研究调查了性别差异和可卡因使用与肝损伤（以肝纤维化为特征）之间的关系。材料和方法：对来自迈阿密成人HIV研究（MASH）队列的544名非洲裔美国人[369名HIV感染者（PLWH）和175名HIV血清阴性]进行了横断面研究。通过有效的自我报告问卷确定可卡因使用情况，并通过尿液筛查确认。空腹血液使用无创纤维化-4 （FIB-4）指数来评估肝纤维化。结果：男性HIV感染者发生肝纤维化的几率是女性HIV感染者的1.79倍（p = 0.038）。与非洲裔美国男性相比，非洲裔美国女性有更高的CD4计数（p = 0.001）和更低的HIV病毒载量（p = 0.011）。与男性相比，吸烟的女性（PLWH和HIV血清阴性）较少（p = 0.002），有害或有害饮酒的女性较少（p < 0.001）。女性的身体质量指数（kg/m(2)）也高于男性（p < 0.001）。在HIV血清阴性的参与者中，肝纤维化与性别差异或可卡因使用没有显著的关联。在感染艾滋病毒的非洲裔美国人中，可卡因使用者发生肝纤维化的可能性是非可卡因使用者的1.68倍（p = 0.044）。结论：性别差异和可卡因的使用似乎会影响非洲裔美国人感染艾滋病毒的肝病，这表明识别高危人群对改善肝病预后的重要性。
Background: HIV infection disproportionally affects African Americans. Liver disease is a major cause of non-HIV morbidity and mortality in this population. Substance abuse accelerates HIV disease and may facilitate progression of liver disease. This study investigated the relationship between sex differences and cocaine use with liver injury, characterized as hepatic fibrosis. Materials and Methods: A cross-sectional study was conducted on 544 African Americans [369 people living with HIV (PLWH) and 175 HIV seronegative] from the Miami Adult Studies on HIV (MASH) cohort. Cocaine use was determined with a validated self-reported questionnaire and confirmed with urine screen. Fasting blood was used to estimate liver fibrosis using the noninvasive fibrosis-4 (FIB-4) index. Results: Men living with HIV had 1.79 times higher odds for liver fibrosis than women living with HIV (p = 0.038). African American women had higher CD4 count (p = 0.001) and lower HIV viral load (p = 0.011) compared to African American men. Fewer women (PLWH and HIV seronegative) smoked cigarettes (p = 0.002), and fewer had hazardous or harmful alcohol use (p < 0.001) than men. Women also had higher body mass index (kg/m(2)) (p < 0.001) compared to men. No significant association was noted among HIV seronegative participants for liver fibrosis by sex differences or cocaine use. Among African Americans living with HIV, cocaine users were 1.68 times more likely to have liver fibrosis than cocaine nonusers (p = 0.044). Conclusions: Sex differences and cocaine use appear to affect liver disease among African Americans living with HIV pointing to the importance of identifying at-risk individuals to improve outcomes of liver disease.