Author: Sims O.T, Wang K, Chiu C, Melton P

Theme: Clinical Research Year: 2019

Background: Biological and behavioral synergistic affects associated with substance and alcohol use in
patients living with HIV/HCV co-infection markedly increases morbidity and mortality, including patients
receiving antiretroviral therapy. Following clinical guidelines, clinicians routinely recommend patients
living with HIV/HCV co-infection to cease substance use and any level of alcohol use. Using a sample of
HIV/HCV co-infected patients who were in routine clinical care receiving antiretroviral therapy, the
objectives of this study were to estimate the prevalence of alcohol use and substance use and to
compare clinical characteristics of those with and without alcohol and substance use.
Methods: This study recruited a sample of HIV/HCV co-infected patients receiving antiretroviral therapy
(n=137) at a university affiliated HIV Clinic between January 2013 and July 2017. Chi-square and the
Student’s t-test were used to compare HIV/HCV co-infected patients with and without substance and
alcohol use.

Results: The prevalence of alcohol use during antiretroviral therapy was 68%. Compared to those
without alcohol use, those with alcohol use were more likely to be non-adherent to antiretroviral
therapy (61% vs. 93%, p = 0.000). The prevalence of substance use during antiretroviral therapy was
31%. Compared to those without substance use, those with substance use had lower levels of quality of
life (0.78 ± 0.18 vs. 0.72 ± 0.17, p=0.031).
Conclusions: Unexpectedly, a significant number of patients who used alcohol did not have alcohol
dependency. The findings highlight a need for clinicians to not overlook HIV/HCV co-infected patients
who are without alcohol use disorders. The findings also suggest an urgent need for behavioral and
pharmacologic interventions in HIV clinical settings to help HIV/HCV co-infected patients achieve
reduction and abstinence from alcohol and substance use.
A Disclosure of Interest Statement: This research was supported by the National Institute on Drug
Abuse of the National Institutes of Health under award R25DA028567 to Dr. Sims.

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