Alcohol-Related Diagnoses Increase the Risk of Hospitalization Among People with HIV

Combination antiretroviral treatment (ART) prolongs survival for individuals living with HIV infection. Increasingly, people with HIV are hospitalized for non AIDS-defining conditions. Alcohol use disorders and other alcohol-related diagnoses (ARD) are common among this population and these individuals may be more susceptible to harm from alcohol. Researchers studied the impact of ARDs on hospitalizations using US Veterans Administration Healthcare System data from 1997 to 2011, comparing patients with HIV (HIV+) with their uninfected counterparts (HIV-).

• There were 46,428 HIV+ and 93,997 HIV- patients included in this study. During this period, 72% of the HIV+ patients were hospitalized compared with 58% of the HIV- patients.
• Hospitalization rates declined over the study period for HIV+ patients (32% decline) and HIV- patients (21%). It also declined for ARD+ patients (21%) and ARD- patients (22%).
• On multivariable analysis of factors associated with the risk of hospitalization, compared with the HIV-/ARD- cohort, the HIV+/ARD+ cohort had an adjusted hazard ratio (HR) of 3.24, the HIV+/ARD- had an HR of 1.85, and the HIV-/ARD+ had an HR of 2.08.

Comments:

This study suggests that ARDs increase the risk of hospitalization for everyone, and particularly for people with HIV. The association between ARDs and smoking may account for some of the increased risk. It remains to be seen whether increased efforts to address ARDs can reduce hospitalizations among this population.

Darius A. Rastegar, MD

Reference:

Rentsch C, Tate JP, Akgün KM, et al. Alcohol-related diagnoses and all-cause hospitalization among HIV-infected and uninfected patients: a longitudinal analysis of United States Veterans from 1997 to 2011. AIDS Behav. 2015 [Epub ahead of print]. doi: 10.​1007/​s10461-015-1025-y.