The Impact of Binge Drinking on Mortality and Liver Disease in the Swiss HIV Cohort Study
Abstract
:1. Introduction
2. Methods
2.1. Swiss HIV Cohort Study and Inclusion Criteria
2.2. Outcomes
2.3. Exposure
2.4. Statistical Analyses
2.5. Sensitivity Analyses
3. Results
3.1. Study Population
3.2. Alcohol Drinking Patterns
3.3. All-Cause and Liver-Related Deaths
3.4. Liver-Related Events
3.5. Sensitivity Analyses
4. Discussion
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Abstinence | Non-Hazardous Drinking | Hazardous Drinking(No Binge) | Binge Drinking | |
---|---|---|---|---|
n | 2718 | 6861 | 1814 | 456 |
Female (%) | 1220 (44.9) | 1697 (24.7) | 287 (15.8) | 60 (13.2) |
Median age, years (IQR) | 47 (39–53) | 47 (39–53) | 45 (36–52) | 46 (36–52) |
Caucasian (%) | 1756 (64.6) | 5436 (79.2) | 1529 (84.3) | 376 (82.5) |
HIV transmission (%) | ||||
Heterosexual | 1333 (49.0) | 2455 (35.8) | 502 (27.7) | 145 (31.8) |
PWID | 516 (19.0) | 559 (8.1) | 197 (10.9) | 75 (16.4) |
MSM | 692 (25.5) | 3483 (50.8) | 1037 (57.2) | 213 (46.7) |
Other | 177 (6.5) | 364 (5.3) | 78 (4.3) | 23 (5.0) |
Education (%) | ||||
No education | 332 (12.2) | 333 (4.9) | 85 (4.7) | 35 (7.7) |
Basic education | 1658 (61.0) | 3838 (55.9) | 976 (53.8) | 266 (58.3) |
Higher education | 604 (22.2) | 2528 (36.8) | 722 (39.8) | 145 (31.8) |
Missing data | 124 (4.6) | 162 (2.4) | 31 (1.7) | 10 (2.2) |
Median nadir CD4, cells/µL (IQR) | 186 (79–294) | 222 (110–338) | 241 (126–380) | 226 (117–373) |
History of AIDS defining disease (%) | 744 (27.4) | 1430 (20.8) | 305 (16.8) | 96 (21.1) |
HBV coinfection (%) | 165 (6.1) | 327 (4.8) | 66 (3.6) | 15 (3.3) |
HCV coinfection (%) | 372 (13.7) | 525 (7.7) | 158 (8.7) | 61 (13.4) |
Smoker (%) | 1203 (44.3) | 2975 (43.4) | 1097 (60.5) | 336 (73.7) |
Unemployed (%) | 1311 (48.2) | 1757 (25.6) | 450 (24.8) | 201 (44.1) |
Lives with partner (%) | 1139 (41.9) | 3351 (48.8) | 782 (43.1) | 158 (34.6) |
Any depressive episode (%) | 1186 (43.6) | 2263 (33.0) | 649 (35.8) | 216 (47.4) |
BMI category (%) | ||||
Normal | 1377 (50.7) | 3840 (56.0) | 1075 (59.3) | 260 (57.0) |
Underweight | 205 (7.5) | 274 (4.0) | 77 (4.2) | 27 (5.9) |
Overweight/obese | 1046 (38.5) | 2624 (38.2) | 633 (34.9) | 158 (34.6) |
Missing data | 90 (3.3) | 123 (1.8) | 29 (1.6) | 11 (2.4) |
Median follow-up, years (IQR) | 6.8 (3.8–7.0) | 6.8 (4.6–7.1) | 6.7 (3.3–7.0) | 6.2 (3.1–7.0) |
All-Cause Deaths | Liver-Related Deaths | Liver-Related Events | ||||||
---|---|---|---|---|---|---|---|---|
Variable | Person-Years | n | Rate per 1000 Person-Years (95% CI) | n | Rate per 1000 Person-Years (95% CI) | Person-Years | n | Rate per 1000 Person-Years (95% CI) |
Overall | 66,153 | 470 | 7.1 (6.5–7.8) | 37 | 0.6 (0.4–0.8) | 65,321 | 239 | 3.7 (3.2–4.2) |
Calendar year 1 | ||||||||
2013 | 8482 | 65 | 7.7 (6.0– 9.8) | 7 | 0.8 (0.4–1.7) | 8459 | 70 | 8.3 (6.5–10.5) |
2014 | 9252 | 60 | 6.5 (5.0–8.4) | 8 | 0.9 (0.4–1.7) | 9176 | 44 | 4.8 (3.6–6.4) |
2015 | 9526 | 96 | 10.1 (8.3–12.3) | 5 | 0.5 (0.2–1.3) | 9417 | 37 | 3.9 (2.8–5.4) |
2016 | 9647 | 69 | 7.2 (5.7–9.1) | 6 | 0.6 (0.3–1.4) | 9510 | 30 | 3.2 (2.2–4.5) |
2017 | 9603 | 83 | 8.6 (7.0–10.7) | 6 | 0.6 (0.3–1.4) | 9451 | 28 | 3.0 (2.0–4.3) |
2018 | 9660 | 66 | 6.8 (5.4–8.7) | 4 | 0.4 (0.2–1.1) | 9496 | 23 | 2.4 (1.6–3.6) |
2019 | 9352 | 30 | 3.2 (2.2–4.6) | 1 | 0.1 (0.0–0.8) | 9194 | 7 | 0.8 (0.4–1.6) |
2020 | 592 | 1 | 1.7 (0.2–12.0) | 0 | 0 | 578 | 0 | 0 |
Transmission risk group | ||||||||
Heterosexual | 25,289 | 145 | 5.7 (4.9–6.7) | 11 | 0.4 (0.2–0.8) | 25,089 | 63 | 2.5 (4.9–6.7) |
PWID | 7466 | 138 | 18.5 (15.6–21.9) | 21 | 2.8 (1.8–4.3) | 7098 | 100 | 14.1 (15.6–21.9) |
MSM | 30,072 | 165 | 5.5 (4.7–6.4) | 5 | 0.2 (0.1–0.4) | 29,839 | 68 | 2.3 (4.7–6.4) |
Other | 3326 | 22 | 6.6 (4.4–10.0) | 0 | 0 | 3294 | 8 | 2.4 (4.4–10.0) |
Alcohol drinking pattern | ||||||||
Abstinence | 16,011 | 205 | 12.8 (11.2–14.7) | 20 | 1.2 (0.8–1.9) | 15,713 | 76 | 4.8 (3.9–6.1) |
Non-hazardous drinking | 36,114 | 187 | 5.2 (4.5–6.0) | 9 | 0.2 (0.1–0.5) | 35,781 | 90 | 2.5 (2.0–3.1) |
Hazardous drinking (no binge) | 11,105 | 42 | 3.8 (2.8–5.1) | 5 | 0.5 (0.2–1.1) | 10,985 | 39 | 3.6 (2.6–4.9) |
Binge drinking | 2923 | 36 | 12.3 (8.9–17.0) | 3 | 1.0 (0.3–3.2) | 2842 | 34 | 12.0 (8.5–16.8) |
Liver-Related Event | n |
---|---|
Cirrhosis (confirmed AST-to-platelet ratio index (APRI-score) above 2) | 140 |
Cirrhosis (based on liver-biopsy) | 28 |
Diagnosis of portal hypertension | 20 |
Hepatocellular carcinoma (HCC) | 20 |
Bleeding from gastric or esophageal varices | 10 |
Hepatic encephalopathy (stage III or IV) | 9 |
Hepatorenal syndrome | 4 |
Liver transplantation | 3 |
Spontaneous bacterial peritonitis (with cirrhosis) | 3 |
Ascites, clinically and confirmed by imaging | 2 |
Total | 239 |
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Surial, B.; Bertholet, N.; Daeppen, J.-B.; Darling, K.E.A.; Calmy, A.; Günthard, H.F.; Stöckle, M.; Bernasconi, E.; Schmid, P.; Rauch, A.; et al. The Impact of Binge Drinking on Mortality and Liver Disease in the Swiss HIV Cohort Study. J. Clin. Med. 2021, 10, 295. https://doi.org/10.3390/jcm10020295
Surial B, Bertholet N, Daeppen J-B, Darling KEA, Calmy A, Günthard HF, Stöckle M, Bernasconi E, Schmid P, Rauch A, et al. The Impact of Binge Drinking on Mortality and Liver Disease in the Swiss HIV Cohort Study. Journal of Clinical Medicine. 2021; 10(2):295. https://doi.org/10.3390/jcm10020295
Chicago/Turabian StyleSurial, Bernard, Nicolas Bertholet, Jean-Bernard Daeppen, Katharine E. A. Darling, Alexandra Calmy, Huldrych F. Günthard, Marcel Stöckle, Enos Bernasconi, Patrick Schmid, Andri Rauch, and et al. 2021. "The Impact of Binge Drinking on Mortality and Liver Disease in the Swiss HIV Cohort Study" Journal of Clinical Medicine 10, no. 2: 295. https://doi.org/10.3390/jcm10020295
APA StyleSurial, B., Bertholet, N., Daeppen, J.-B., Darling, K. E. A., Calmy, A., Günthard, H. F., Stöckle, M., Bernasconi, E., Schmid, P., Rauch, A., Furrer, H., Wandeler, G., & The Swiss HIV Cohort Study. (2021). The Impact of Binge Drinking on Mortality and Liver Disease in the Swiss HIV Cohort Study. Journal of Clinical Medicine, 10(2), 295. https://doi.org/10.3390/jcm10020295