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
{"title":"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","authors":"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","doi":"10.1097/QAD.0000000000004329","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Tobacco smoking and alcohol use may negatively influence HIV care, but associations have not been examined across cohorts.</p><p><strong>Design: </strong>Multisite international collaboration of cohort studies.</p><p><strong>Methods: </strong>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).</p><p><strong>Results: </strong>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%.</p><p><strong>Conclusions: </strong>Smoking and unhealthy alcohol use were associated with HIV loss to care and viral non-suppression, with variability between cohorts.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":" ","pages":""},"PeriodicalIF":3.1000,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The relationship of smoking and unhealthy alcohol use to HIV care retention and viral suppression: findings from a multi-site cohort study.\",\"authors\":\"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\",\"doi\":\"10.1097/QAD.0000000000004329\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>Tobacco smoking and alcohol use may negatively influence HIV care, but associations have not been examined across cohorts.</p><p><strong>Design: </strong>Multisite international collaboration of cohort studies.</p><p><strong>Methods: </strong>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).</p><p><strong>Results: </strong>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%.</p><p><strong>Conclusions: </strong>Smoking and unhealthy alcohol use were associated with HIV loss to care and viral non-suppression, with variability between cohorts.</p>\",\"PeriodicalId\":7502,\"journal\":{\"name\":\"AIDS\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.1000,\"publicationDate\":\"2025-09-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"AIDS\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/QAD.0000000000004329\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"IMMUNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"AIDS","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/QAD.0000000000004329","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
The relationship of smoking and unhealthy alcohol use to HIV care retention and viral suppression: findings from a multi-site cohort study.
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.
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.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
