Alcohol Overuse Is Often Undiagnosed in HIV-Infected Persons

Scientists evaluated the ability of the carbohydrate-deficient transferrin (CDT) biomarker to detect unhealthy alcohol consumption among people infected with Human immunodeficiency virus (HIV).

Although CDT, often measured as %CDT, can detect very heavy drinking, whether it does so in people with HIV in a clinically useful manner has yet to be established.

Investigators at the Boston University School of Medicine (BUSM; MA, USA) and colleagues evaluated the ability of %CDT and gamma glutamyltransferase to detect three levels of unhealthy alcohol consumption: at-risk, heavy, and frequent heavy drinking as determined by a reference standard questionnaire.

Of 300 subjects, 103 reported current consumption at at-risk amounts, and 47 reported heavy amounts. For at-risk drinking, sensitivity of %CDT was 28 %, meaning the test detected only 28 % of those with unhealthy alcohol use. For heavy drinking, sensitivity was 36 %. According to the scientists, these findings suggest that %CDT is not sufficiently sensitive for use in screening for unhealthy alcohol use by people with HIV infection.

"There is evidence that early intervention for unhealthy alcohol use can be effective but early clinical signs are often missed and unhealthy alcohol use often goes undiagnosed by HIV healthcare providers," explained principal investigator Jeffrey Samet, MD, MA, MPH, professor of medicine at BUSM. "Unfortunately among HIV-infected adults with alcohol problems, %CDT had poor overall accuracy for detecting unhealthy drinking," he added.

Alcohol use is common in HIV-infected persons. It can interfere with HIV medication adherence, lower CD4 cell count, and even cause hepatic injury. Furthermore, HIV coinfection with viral hepatitis is common and both HIV and viral hepatitis are adversely impacted by alcohol. For these reasons, detection of unhealthy alcohol use is important in the clinical care of HIV-infected individuals.

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Boston University School of Medicine