The relationship of smoking and unhealthy alcohol use to HIV care retention and viral suppression: findings from a multi-site cohort study.

IF 3.1 2区医学 Q3 IMMUNOLOGY

AIDS Pub Date : 2025-09-04 DOI:10.1097/QAD.0000000000004329

Derek D Satre, Varada Sarovar, Tory Levine, Stacey Alexeeff, Alexandra Lea, Stacy A Sterling, Amy C Justice, Jodie L Guest, Jonathan A C Sterne, Suzanne M Ingle, Adam Trickey, Matthias Cavassini, Michael S Saag, Heidi M Crane, Enrico Girardi, Inma Jarrin, M John Gill, Linda Wittkop, Marc van der Valk, Roger D Kouyos, Robert Zangerle, Michael J Silverberg

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引用次数: 0

Abstract

Objectives: Tobacco smoking and alcohol use may negatively influence HIV care, but associations have not been examined across cohorts.

Design: Multisite international collaboration of cohort studies.

Methods: People with HIV (PWH) were included from 11 cohorts; 5 North American and 6 Western European. Exposures were harmonized smoking and alcohol measures (2010-2018). Loss to care was defined as not having 2+ HIV care visits (HIV RNA and/or CD4 measurement dates) at least 60 days apart, within 12 months following alcohol measure date; HIV viral non-suppression was defined as >200 copies/mL. We calculated adjusted prevalence ratios (PRs) with modified Poisson regression, pooled effect estimates by random-effect meta-analysis, and variability (I2).

Results: Among 83,102 PWH (87.4% male, 46.1% white); 43.7% currently smoked, 44.5% reported low/moderate drinking, 6.9% heavy drinking, 48.6% did not drink. PWH who currently smoked had higher risk of loss to care than non-smoking PWH (pooled PR [95% CI]=1.12 [1.08-1.16], I2 = 18.1%); those with heavy drinking had higher risk than those with low/moderate drinking (1.13 [1.03-1.25], I2 = 57.8%). PWH who currently smoked had higher risk of viral non-suppression than non-smoking PWH (1.44 [1.25-1.67], I2 = 90.6%); those reporting heavy drinking had higher risk than those with low/moderate drinking (pooled PR [95% CI]=1.18 [1.02-1.37], I2 = 68.9%). PWH who reported heavy drinking and current smoking, in comparison to low/moderate alcohol use but no current smoking, had highest risk of viral non-suppression (pooled PR [95% CI] =1.74 [1.37-2.22]), I2 = 81.8%.

Conclusions: Smoking and unhealthy alcohol use were associated with HIV loss to care and viral non-suppression, with variability between cohorts.

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吸烟和不健康饮酒与HIV护理保留和病毒抑制的关系：一项多地点队列研究的结果

目的：吸烟和饮酒可能对艾滋病毒护理产生负面影响，但尚未对各队列之间的关联进行研究。设计：多地点国际合作队列研究。方法：从11个队列中纳入HIV感染者（PWH）；北美5个，西欧6个。暴露是统一的吸烟和饮酒措施（2010-2018年）。失去护理被定义为在酒精测量日期后的12个月内，间隔至少60天没有进行2次以上的艾滋病毒护理访问（艾滋病毒RNA和/或CD4测量日期）；HIV病毒无抑制定义为bb0 200拷贝/mL。我们使用修正泊松回归计算校正患病率（pr），通过随机效应荟萃分析和变异性计算合并效应估计（I2）。结果：83,102名PWH患者中，男性87.4%，白人46.1%；43.7%目前吸烟，44.5%轻度/中度饮酒，6.9%重度饮酒，48.6%不饮酒。目前吸烟的PWH患者失去护理的风险高于不吸烟的PWH患者（合并PR [95% CI]=1.12 [1.08-1.16], I2 = 18.1%）；重度饮酒者的发病风险高于低/中度饮酒者（1.13 [1.03-1.25],I2 = 57.8%）。目前吸烟的PWH患者的病毒不抑制风险高于不吸烟的PWH患者（1.44 [1.25-1.67],I2 = 90.6%）；重度饮酒者的发病风险高于低/中度饮酒者（合并PR [95% CI]=1.18 [1.02-1.37], I2 = 68.9%）。与低/中度饮酒但目前不吸烟的PWH患者相比，报告大量饮酒和吸烟的PWH患者病毒无抑制的风险最高（合并PR [95% CI] =1.74 [1.37-2.22]）， I2 = 81.8%。结论：吸烟和不健康的酒精使用与HIV失去治疗和病毒未抑制相关，在队列之间存在差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

AIDS 医学-病毒学

CiteScore

5.90

自引率

5.30%

发文量

478

审稿时长

3 months

期刊介绍： Publishing the very latest ground breaking research on HIV and AIDS. Read by all the top clinicians and researchers, AIDS has the highest impact of all AIDS-related journals. With 18 issues per year, AIDS guarantees the authoritative presentation of significant advances. The Editors, themselves noted international experts who know the demands of your work, are committed to making AIDS the most distinguished and innovative journal in the field. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.