Background
Methods
Study participants
Classification of alcohol consumption
Definitions of covariates
Definition of severe liver disease
Statistical analyses
Results
Alcohol consumption
Patient characteristics
Baseline characteristics | Abstainers (N = 3422) | Moderate (N = 2279) | Hazardous (N = 637) | Total (N = 6338) |
---|---|---|---|---|
Gender, n(%) | ||||
Male | 2363 (69.1%) | 1954 (85.7%) | 567 (89.0%) | 4884 (77.1%) |
Female | 1059 (30.9%) | 325 (14.3%) | 70 (11.0%) | 1454 (22.9%) |
Age, years | ||||
Median (IQR) | 38 (31, 47) | 37 (30, 45) | 41 (34, 49) | 38 (31, 46) |
Mode of HIV Transmission, n(%) | ||||
PWID | 367 (10.7%) | 250 (11.0%) | 114 (17.9%) | 731 (11.5%) |
Homosexual contacts | 1317 (38.5%) | 1124 (49.3%) | 222 (34.9%) | 2663 (42.0%) |
Heterosexual contacts | 1517 (44.3%) | 757 (33.2%) | 269 (42.2%) | 2543 (40.1%) |
Other/Unknown | 221 (6.5%) | 148 (6.5%) | 32 (5.0%) | 401 (6.3%) |
Nationality, n(%) | ||||
Italian | 2572 (75.2%) | 1915 (84.0%) | 516 (81.0%) | 5003 (78.9%) |
Region, n(%) | ||||
North | 1577 (46.1%) | 1144 (50.2%) | 382 (60.0%) | 3103 (49.0%) |
Center | 1366 (39.9%) | 866 (38.0%) | 217 (34.1%) | 2449 (38.6%) |
South | 479 (14.0%) | 269 (11.8%) | 38 (6.0%) | 786 (12.4%) |
AIDS diagnosis, n(%) | ||||
Yes | 336 (9.8%) | 156 (6.8%) | 43 (6.8%) | 535 (8.4%) |
CD4 count cells/mm3, n(%) | ||||
≤ 300 | 1156 (33.8%) | 580 (25.4%) | 172 (27.0%) | 1908 (30.1%) |
301–500 | 810 (23.7%) | 593 (26.0%) | 166 (26.1%) | 1569 (24.8%) |
≥ 501 | 1035 (30.2%) | 861 (37.8%) | 216 (33.9%) | 2112 (33.3%) |
Unknown | 421 (12.3%) | 245 (10.8%) | 83 (13.0%) | 749 (11.8%) |
HIV-RNA viral load, n(%) | ||||
≤ 5000 | 605 (17.7%) | 389 (17.1%) | 114 (17.9%) | 1108 (17.5%) |
5001–10,000 | 208 (6.1%) | 172 (7.5%) | 48 (7.5%) | 428 (6.8%) |
10,001–100,000 | 1222 (35.7%) | 922 (40.5%) | 231 (36.3%) | 2375 (37.5%) |
≥ 100,001 | 1025 (30.0%) | 567 (24.9%) | 179 (28.1%) | 1771 (27.9%) |
Unknown | 362 (10.6%) | 229 (10.0%) | 65 (10.2%) | 656 (10.4%) |
Smoking, n(%) | ||||
No | 2201 (64.3%) | 924 (40.5%) | 188 (29.5%) | 3313 (52.3%) |
Yes | 1092 (31.9%) | 1268 (55.6%) | 413 (64.8%) | 2773 (43.8%) |
Unknown | 129 (3.8%) | 87 (3.8%) | 36 (5.7%) | 252 (4.0%) |
Hepatitis B, n(%) | ||||
Yes | 107 (3.1%) | 59 (2.6%) | 25 (3.9%) | 191 (3.0%) |
HCV Infection, n(%) | ||||
Negative | 2366 (69.1%) | 1549 (68.0%) | 409 (64.2%) | 4324 (68.2%) |
Positive | 410 (12.0%) | 250 (11.0%) | 119 (18.7%) | 779 (12.3%) |
Not tested | 646 (18.9%) | 480 (21.1%) | 109 (17.1%) | 1235 (19.5%) |
Calendar year, n(%) | ||||
2002–2006 | 473 (13.8%) | 313 (13.7%) | 69 (10.8%) | 855 (13.5%) |
2007–2012 | 1113 (32.5%) | 671 (29.4%) | 218 (34.2%) | 2002 (31.6%) |
2013–2016 | 1836 (53.7%) | 1295 (56.8%) | 350 (54.9%) | 3481 (54.9%) |
Follow-up (months) | ||||
Median (IQR) | 26.5 (7.4, 57.1) | 23.4 (4.8, 53.5) | 25.6 (5.6, 54.8) | 25.2 (6.1, 55.6) |
Alcohol consumption and risk of severe liver disease
Unadjusted RH[95%CI] | p-value | global p-value | Model 1 RH[95%CI] | p-value | global p-value | Model 2 RH[95%CI] | p-value | global p-value | Model 3 RH[95%CI] | p-value | global p-value | Model 4 RH[95%CI] | p-value | global p-value | |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Alcohol consumption | |||||||||||||||
Abstainer | 1.09 (0.87, 1.38) | 0.446 | <.001 | 1.08 (0.85, 1.37) | 0.506 | <.001 | 1.06 (0.84, 1.34) | 0.640 | 0.007 | 1.10 (0.87, 1.40) | 0.413 | 0.009 | 1.09 (0.86, 1.38) | 0.498 | 0.446 |
Moderate | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | ||||||||||
Hazardous | 1.61 (1.16, 2.26) | 0.005 | 1.45 (1.04, 2.04) | 0.028 | 1.45 (1.03, 2.03) | 0.031 | 1.30 (0.95, 1.86) | 0.129 | 1.32 (0.94, 1.85) | 0.107 | |||||
Unknown | 1.67 (1.34, 2.09) | <.001 | 1.56 (1.24, 1.95) | <.001 | 1.37 (1.09, 1.72) | 0.007 | 1.43 (1.13, 1.80) | 0.003 | 1.12 (0..86, 1.46) | 0.408 | |||||
Gender | |||||||||||||||
Male vs Female | 1.17 (0.96, 1.43) | 0.117 | 0.117 | 1.12 (0.91, 1.38) | 0.286 | 0.286 | 1.13 (0.92, 1.39) | 0.259 | 0.259 | 1.15 (0.92, 1.43) | 0.213 | 0.213 | 1.15 (0.92, 1.43) | 0.217 | 0.217 |
Age, years | |||||||||||||||
per 10 years older | 1.60 (1.50, 1.71) | <.001 | <.001 | 1.56 (1.45, 1.67) | <.001 | <.001 | 1.48 (1.37, 1.59) | <.001 | <.001 | 1.47 (1.36, 1.59) | <.001 | <.001 | 1.46 (1.34, 1.58) | <.001 | <.001 |
Nationality | |||||||||||||||
Italian vs Non-Italian | 1.75 (1.36, 2.25) | <.001 | <.001 | 1.26 (0.97, 1.65) | 0.081 | 0.081 | 1.20 (0.92, 1.56) | 0.184 | 0.184 | 0.97 (0.74, 1.27) | 0.829 | 0.829 | 0.98 (0.74, 1.28) | 0.877 | 0.877 |
Geographical Region | |||||||||||||||
North | 1.00 | 0.096 | 1.00 | 0.341 | 1.00 | 0.242 | 1.00 | 0.391 | 1.00 | 0.353 | |||||
Center | 0.83 (0.69, 0.98) | 0.031 | 0.90 (0.75, 1.07) | 0.226 | 0.88 (0.74, 1.05) | 0.157 | 0.94 (0.79, 1.13) | 0.553 | 0.95 (0.79, 1.14) | 0.596 | |||||
South | 0.95 (0.72, 1.27) | 0.739 | 1.08 (0.81, 1.44) | 0.601 | 1.09 (0.81, 1.46) | 0.584 | 1.16 (0.87, 1.58) | 0.291 | 1.19 (0.89, 1.60) | 0.240 | |||||
Calendar year enrolled | |||||||||||||||
2002–2006 | 1.00 | <.001 | 1.00 | <.001 | 1.00 | <.001 | 1.00 | <.001 | 1.00 | <.001 | |||||
2007–2012 | 0.57 (0.45, 0.71) | <.001 | 0.52 (0.41, 0.66) | <.001 | 0.51 (0.40, 0.65) | <.001 | 0.63 (0.49, 0.79) | <.001 | 0.59 (0.46, 0.75) | <.001 | |||||
2012–2016 | 1.08 (0.86, 1.35) | 0.511 | 0.88 (0.70, 1.11) | 0.269 | 0.67 (0.53, 0.86) | 0.001 | 0.69 (0.54, 0.89) | 0.005 | 0.64 (0.49, 0.82) | <.001 | |||||
AIDS Diagnosis | |||||||||||||||
Yes vs, No | 1.64 (1.30, 2.07) | <.001 | <.001 | – | 1.34 (1.05, 1.73) | 0.021 | 0.021 | 1.40 (1.09, 1.79) | 0.008 | 0.008 | 1.40 (1.09, 1.80) | 0.008 | 0.008 | ||
CD4 count | |||||||||||||||
≤ 300 | 1.00 | <.001 | – | 1.00 | <.001 | 1.00 | <.001 | 1.00 | <.001 | ||||||
301–500 | 0.69 (0.54, 0.90) | 0.005 | – | 0.86 (0.65, 1.13) | 0.280 | 0.91 (0.68, 1.19) | 0.487 | 0.91 (0.69, 1.19) | 0.491 | ||||||
> 500 | 0.96 (0.77, 1.20) | 0.724 | – | 1.22 (0.95, 1.56) | 0.113 | 1.39 (1.07, 1.78) | 0.010 | 1.39 (1.08, 1.80) | 0.008 | ||||||
Unknown | 3.36 (2.72, 4.16) | <.001 | – | 4.93 (3.60, 6.75) | <.001 | 2.62 (1.86, 3.70) | <.001 | 2.43 (1.72, 3.44) | <.001 | ||||||
Viral load, copies/mL | |||||||||||||||
≤5000 | 1.00 | <.001 | – | 1.00 | <.001 | 1.00 | 0.012 | 1.00 | 0.010 | ||||||
5000–10,000 | 0.64 (0.44, 0.93) | 0.018 | – | 1.09 (0.73, 1.62) | 0.670 | 1.53 (1.02, 2.30) | 0.041 | 1.55 (1.03, 2.33) | 0.034 | ||||||
10,000–100,000 | 0.63 (0.50, 0.79) | <.001 | – | 1.12 (0.86, 1.45) | 0.410 | 1.57 (1.19, 2.07) | 0.001 | 1.59 (1.21, 2.10) | 0.001 | ||||||
> 100,000 | 0.71 (0.56, 0.90) | 0.005 | – | 1.08 (0.82, 1.43) | 0.566 | 1.63 (1.21, 2.19) | 0.001 | 1.64 (1.22, 2.22) | 0.001 | ||||||
Unknown | 1.43 (1.12, 1.83) | 0.005 | – | 0.57 (0.44, 0.76) | <.001 | 1.05 (0.79, 1.38) | 0.752 | 1.06 (0.80, 1.40) | 0.652 | ||||||
HBV infection | |||||||||||||||
Yes vs, No | 1.91 (1.33, 2.74) | <.001 | <.001 | – | 1.92 (1.34, 2.77) | <.001 | <.001 | 1.97 (1.37, 2.84) | <.001 | <.001 | 2.03 (1.41, 2.93) | <.001 | <.001 | ||
Mode of HIV Transmission | |||||||||||||||
PWID | 1.00 | <.001 | – | – | 1.00 | <.001 | 1.00 | <.001 | |||||||
MSM | 0.15 (0.13, 0.19) | <.001 | – | – | 0.45 (0.34, 0.59) | <.001 | 0.44 (0.33, 0.58) | <.001 | |||||||
Heterosexual contacts | 0.18 (0.15, 0.22) | <.001 | – | – | 0.44 (0.33, 0.58) | <.001 | 0.43 (0.32, 0.57) | <.001 | |||||||
Other | 0.32 (0.24, 0.43) | <.001 | – | – | 0.64 (0.47, 0.89) | 0.008 | 0.62 (0.45, 0.86) | 0.004 | |||||||
HCV infection | |||||||||||||||
No | 1.00 | <.001 | – | – | 1.00 | <.001 | 1.00 | <.001 | |||||||
Yes | 7.10 (5.89, 8.55) | <.001 | – | – | 2.91 (2.22, 3.82) | <.001 | 2.94 (2.24, 3.86) | <.001 | |||||||
Unknown | 1.67 (1.37, 2.05) | <.001 | – | – | 1.36 (1.10, 1.69) | 0.005 | 1.34 (1.08, 1.67) | 0.007 | |||||||
Smoking status | |||||||||||||||
No | 1.00 | <.001 | – | – | – | 1.00 | 0.001 | ||||||||
Yes | 1.39 (1.13, 1.70) | 0.001 | – | – | – | 0.91 (0.73, 1.13) | 0.405 | ||||||||
Unknown | 2.30 (1.89, 2.80) | <.001 | – | – | – | 1.46 (1.12, 1.91) | 0.006 | ||||||||
With Multiple Imputation | |||||||||||||||
Alcohol consumption | |||||||||||||||
Abstainer | 1.15 (0.90, 1.47) | 0.261 | 1.13 (0.88, 1.45) | 0.339 | 1.11 (0.87, 1.42) | 0.394 | 1.13 (0.89, 1.44) | 0.315 | 1.13 (0.88, 1.45) | 0.353 | 0.724 | ||||
Moderate | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | ||||||||||
Hazardous | 1.70 (1.24, 2.34) | 0.002 | 1.48 (1.07, 2.05) | 0.020 | 1.43 (1.03, 1.99) | 0.037 | 1.29 (0.93, 1.78) | 0.120 | 1.30 (0.94, 1.81) | 0.114 |