The J-Curve in HIV: Low and Moderate Alcohol Intake Predicts Mortality but Not the Occurrence of Major Cardiovascular Events

WANDELER, G, David KRAUS, J FEHR, A CONEN, A CALMY, C ORASCH, M BATTEGAY, P SCHMID, E BERNASCONI and H FURRER. The J-Curve in HIV: Low and Moderate Alcohol Intake Predicts Mortality but Not the Occurrence of Major Cardiovascular Events. JAIDS: Journal of Acquired Immune Deficiency Syndromes. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS, 2016, vol. 71, No 3, p. 302-309. ISSN 1525-4135. Available from: https://dx.doi.org/10.1097/QAI.0000000000000864.

Basic information

• Original name: The J-Curve in HIV: Low and Moderate Alcohol Intake Predicts Mortality but Not the Occurrence of Major Cardiovascular Events
• Authors: WANDELER, G, David KRAUS, J FEHR, A CONEN, A CALMY, C ORASCH, M BATTEGAY, P SCHMID, E BERNASCONI and H FURRER.
• Edition: JAIDS: Journal of Acquired Immune Deficiency Syndromes, PHILADELPHIA, LIPPINCOTT WILLIAMS & WILKINS, 2016, 1525-4135.

Other information

• Original language: English
• Type of outcome: Article in a journal
• Confidentiality degree: is not subject to a state or trade secret
• WWW: URL
• Impact factor: Impact factor: 3.935
• Doi: http://dx.doi.org/10.1097/QAI.0000000000000864
• UT WoS: 000371522100009
• Keywords in English: HIV infection; alcohol consumption; mortality; cohort study; cardiovascular diseases
• Tags: International impact, Reviewed

Abstract

Objectives: In HIV-negative populations, light-to-moderate alcohol consumption is associated with a lower cardiovascular morbidity and mortality than alcohol abstention. Whether the same holds true for HIV-infected individuals has not been evaluated in detail. Design: Cohort study. Methods: Adults on antiretroviral therapy in the Swiss HIV Cohort Study with follow-up after August 2005 were included. We categorized alcohol consumption into: abstention or very low (<1 g/d), low (1-9 g/d), moderate (10-29 g/d in women and 10-39 g/d in men), and high alcohol intake. Cox proportional hazards models were used to describe the association between alcohol consumption and cardiovascular disease-free survival (combined endpoint), cardiovascular disease events (CADE) and overall survival. Baseline and time-updated risk factors for CADE were included in the models. Results: Among 9741 individuals included, there were 788 events of major CADE or death during 46,719 patient-years of follow-up, corresponding to an incidence of 1.69 events/100 person-years. Follow-up according to alcohol consumption level was 51% no or very low, 20% low, 23% moderate, and 6% high intake. As compared with no or very low alcohol intake, low (hazard ratio 0.79, 95% confidence interval 0.63 to 0.98) and moderate alcohol intakes (0.78, 0.64 to 0.95) were associated with a lower incidence of the combined endpoint. There was no significant association between alcohol consumption and CADE. Conclusions: Compared with no or very low alcohol consumption, low and moderate intake associated with a better CADE-free survival. However, this result was mainly driven by mortality and the specific impact of drinking patterns and type of alcoholic beverage on this outcome remains to be determined.