Alcohol consumption and lipodystrophy in HIV-infected adults with alcohol problems
Alcohol consumption and lipodystrophy in HIV-infected adults with alcohol problems
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DOI：
10.1016/j.alcohol.2008.09.004
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发表时间：
2009-02-01
期刊：
影响因子：
2.3
通讯作者：
Samet, Jeffrey H.
中科院分区：
文献类型：
--
作者：
Cheng, Debbie M.;Libman, Howard;Samet, Jeffrey H.
脂肪营养不良是HIV感染的一种常见的长期并发症，可能导致生活质量下降和抗逆转录病毒治疗（ART）依从性降低。尽管与病毒本身相关的因素和抗逆转录病毒治疗的使用似乎相关，但对艾滋病毒相关脂肪营养不良的病因学尚未完全了解。酒精在艾滋病毒感染患者中很常见，对脂肪分布有生物学影响，但酒精与艾滋病毒相关的脂肪营养不良的关系尚未得到研究。本临床研究的目的是评估酒精摄入对有酒精问题的hiv感染成人脂肪营养不良的影响，这是一项前瞻性研究（2001-2006），289名有酒精问题的hiv感染者。主要终点是自我报告的脂肪营养不良，在一个时间点（入组后中位29个月）进行评估。每6个月评估一次酒精使用情况，并将其分类为：在所有访谈中戒酒；>= 1例中度饮酒但无重度饮酒报告；1或2例重度饮酒报告；或者>= 3例重度饮酒报告。采用多变量logistic回归模型对数据进行拟合。52%（150/289）的受试者报告了脂肪营养不良。在所有的访谈中，34%的人戒酒；12% >= 1例中度饮酒，但无重度饮酒；34% 1-2例重度饮酒报告；20% >= 3例重度饮酒报告。虽然没有统计学意义，但饮酒的受试者出现脂肪营养不良的几率更高（校正优势比和95%置信区间：>= 1中度饮酒报告，2.36[0.89,6.24]；1-2重度饮酒报告，1.34[0.69,2.60];>= 3重度饮酒报告，2.07[0.90,4.73]）。在有酒精问题的人群中，饮酒可能会增加发生与hiv相关的脂肪营养不良的几率。然而，需要更大规模的研究来充分阐明饮酒对艾滋病毒感染这一常见长期并发症的发展及其治疗的作用和影响。(C) 2009爱思唯尔公司版权所有。
Lipodystrophy is a common long-term complication of HIV infection that may lead to decreased quality of life and less adherence to antiretroviral therapy (ART). A complete understanding of the etiology of HIV-associated lipodystrophy has not yet been achieved, although factors related to the virus, per se, and use of ART appear to be related. Alcohol use is common among HIV-infected patients and has biological effects on fat distribution, yet alcohol's relationship to HIV-associated lipodystrophy has not been examined. The goal of this clinical study was to assess the effect of alcohol consumption on lipodystrophy in HIV-infected adults with alcohol problems, This was a prospective study (2001-2006) of 289 HIV-infected persons with alcohol problems. The primary outcome was self-reported lipodystrophy, which was assessed at one time point (median 29 months after enrollment). Alcohol use was assessed every 6 months and classified as: abstinent at all interviews; >= 1 report of moderate drinking but no heavy drinking; I or 2 reports of heavy drinking; or >= 3 reports of heavy drinking. Multivariable logistic regression models were fit to the data. Fifty-two percent (150/289) of subjects reported lipodystrophy. Alcohol consumption was: 34% abstinent at all interviews; 12% >= 1 report of moderate drinking, but no heavy drinking; 34% 1-2 reports of heavy drinking; and 20% >= 3 reports of heavy drinking. Although not statistically significant, subjects with alcohol use had a higher odds of lipodystrophy (adjusted odds ratios and 95% confidence interval: >= 1 report of moderate drinking, 2.36 [0.89, 6.24]; 1-2 reports of heavy drinking, 1.34 [0.69, 2.60]; >= 3 reports of heavy drinking, 2.07 [0.90, 4.73]). Alcohol use may increase the odds of developing HIVassociated lipodystrophy among subjects with alcohol problems. However, larger studies are needed to fully elucidate the role and impact of alcohol consumption on the development of this common long-term complication of HIV infection and its treatment. (C) 2009 Elsevier Inc. All rights reserved.