Alcohol and Mortality: Combining Self-Reported (AUDIT-C) and Biomarker Detected (PEth) Alcohol Measures Among HIV Infected and Uninfected
Alcohol and Mortality: Combining Self-Reported (AUDIT-C) and Biomarker Detected (PEth) Alcohol Measures Among HIV Infected and Uninfected
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DOI：
10.1097/qai.0000000000001588
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发表时间：
2018-02-01
影响因子：
3.6
通讯作者：
Tate, Janet P.
中科院分区：
文献类型：
--
作者：
Eyawo, Oghenowede;McGinnis, Kathleen A.;Tate, Janet P.
背景资料：不健康的酒精使用可能对艾滋病毒和/或丙型肝炎病毒（HCV）感染者特别有害，并且经常被低估。酒精暴露的直接生物标志物可能有助于改善检测酒精use.Methods：我们评估了酒精暴露的相关性确定的自我报告[酒精使用障碍识别测试-消费（AUDIT-C）]和直接生物标志物[磷脂酰乙醇（PEth）]，与死亡率之间的HIV感染和HIV未感染的退伍军人老龄化队列研究-生物标志物队列。我们认为PEth = 8表明最近接触过酒精。在AUDIT-C = 0的患者中，HCV+个体更有可能患有PEth >= 8。在控制年龄、性别、种族、HIV、HCV和HIV病毒抑制后，AUDIT-C = 0但PEth >= 8的患者死亡风险最高（校正后的风险比为2.15，95%置信区间：1.40 - 3.29）。除了自我报告外，PEth还可以改善临床环境中酒精使用的检测，特别是那些因饮酒而受到伤害的风险增加的人。感染HCV的人更有可能少报饮酒。
Background: Unhealthy alcohol use may be particularly detrimental among individuals living with HIV and/or hepatitis C virus (HCV), and is often under-reported. Direct biomarkers of alcohol exposure may facilitate improved detection of alcohol use.Methods: We evaluated the association of alcohol exposure determined by both self-report [Alcohol Use Disorders Identification Test-Consumption (AUDIT-C)] and a direct biomarker [phosphatidylethanol (PEth)], with mortality among HIV-infected and HIV-uninfected in the Veterans Aging Cohort Study-Biomarker Cohort. We considered PEth = 8 suggesting recent alcohol exposure. Among those with AUDIT-C = 0, HCV+ individuals were more likely to have PEth >= 8. After controlling for age, sex, race, HIV, HCV, and HIV viral suppression, those with AUDIT-C = 0 but PEth >= 8 had the highest risk of mortality (adjusted hazard ratio 2.15, 95% confidence interval: 1.40 to 3.29).Conclusions: PEth in addition to self-report may improve detection of alcohol use in clinical settings, particularly among those at increased risk of harm from alcohol use. Individuals infected with HCV were more likely to under-report alcohol use.