Abstract P325: Cardiometabolic Factors Associated With Alcohol Use; The New Orleans Alcohol Use In Hiv Study

Abstract

As people living with HIV (PLWH) live longer, morbidity and mortality related to chronic illness specifically, cardiovascular disease (CVD) has increased. HIV disease has been associated with hypertension (HTN) and dyslipidemia, which are risk factors for developing CVD. The objective of this study was to determine whether heavy alcohol use among PLWH is associated with increased risk of HTN, dyslipidemia, and metabolic syndrome (MS). To investigate this hypothesis we analyzed data from the New Orleans Alcohol Use in HIV (NOAH) Study. Alcohol use was assessed with the Alcohol Use Disorders Identification Test (AUDIT), the Timeline Follow Back (TLFB) Calendar, a Lifetime Drinking History, and the biomarker, Phosphatidylethanol (PEth). HTN stage 1, was defined as a mean systolic 130-139 or diastolic blood pressure 80-89 mmHg; HTN stage 2 as a systolic ≥140 or diastolic ≥ 90 mmHg. MS was defined as having 3 of 5 conditions: HTN, low high-density lipoproteins (≤40 (men)/50 (women)), high triglycerides (≥ 150mg/dl), high glucose (≥100 mg/dl), waist circumference >88(women)/102(men). The NOAH study cohort (n=365) is majority African American (83.6%), mean age 48.2 ±10.4, 68.8% male and 31.2% female. Descriptive statistics and multivariable linear and logistic regression analyses were performed stratifying by sex and adjusting for age, race, smoking, and viral load. Approximately, 41.3% had an AUDIT ≥8 and 14.0% were hazardous drinkers (greater than 40 (women)/60 (men) grams of alcohol per day). MS was prevalent in 36.1%, stage 2 HTN 66.0%, 9.3% with hyperglycemia (>125mg/dl), 23.0% had elevated creatinine, and 27.4% were obese. Creatinine was positively associated with LDH and PEth (p-value <0.04). TLFB grams of alcohol had a positive linear association with glucose among men (beta=0.0033; p=0.0035). LDH was associated with two-fold increase odds of MS (OR=2.69; 95% C.I.: 1.18 - 9.58) with sex as an effect modifier. AUDIT score ≥8 was not a significant predictor of hypertension, dyslipidemia, or MS in adjusted models. Our preliminary results indicate that lifetime drinking history was more associated with increased cardiometabolic risk than recent drinking. As PLWH are living longer, hazardous and chronic alcohol use is a lifestyle choice that has clinical relevance and has to be addressed in the chronic care model of treatment in PLWH. (Supported by: NIH P60AA009803)