Biomarker-Measured Unhealthy Alcohol Use in Relation to CD4 Count Among Individuals Starting ART in Sub-Saharan Africa

the META team

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Individuals are initiating antiretroviral therapy (ART) at earlier HIV disease stages. Unhealthy alcohol use is a known barrier to successful HIV treatment outcomes, yet it is unclear whether the problem varies by disease stage. We measured alcohol use with an objective biomarker (phosphatidylethanol [PEth]), comparing individuals (n = 401) with early (CD4 > 350 cells/mL, WHO Stage 1) versus late (CD4 < 200 cells/mL) ART initiation in HIV care in Uganda and South Africa (SA). We examined the association between CD4 count and biomarker results using multivariable regression modeling, and compared PEth results to self-report to assess underreporting. Overall, 32.2% (n = 129) had unhealthy alcohol use (PEth ≥ 50 ng/ml). Early ART initiation was significantly associated with unhealthy alcohol use in Uganda (AOR 2.65; 95% CI: 1.05–6.72), but not SA (AOR 1.00; 95% CI: 0.46–2.17). In Uganda, 23.2% underreported unhealthy alcohol use versus 11.6% in SA (χ2 = 9.30; p < 0.01). Addressing unhealthy alcohol use is important as patients initiate ART earlier, yet challenging due to underreporting.

Original languageEnglish (US)
JournalAIDS and Behavior
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Africa South of the Sahara
CD4 Lymphocyte Count
Biomarkers
Alcohols
Uganda
South Africa
HIV
Therapeutics
Secondary Prevention
Self Report
phosphatidylethanol

Keywords

  • Alcohol use
  • Biomarker
  • HIV treatment
  • Sub-Saharan Africa

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Cite this

@article{32e7c86d3b3f452ebeb7c95b176f4580,
title = "Biomarker-Measured Unhealthy Alcohol Use in Relation to CD4 Count Among Individuals Starting ART in Sub-Saharan Africa",
abstract = "Individuals are initiating antiretroviral therapy (ART) at earlier HIV disease stages. Unhealthy alcohol use is a known barrier to successful HIV treatment outcomes, yet it is unclear whether the problem varies by disease stage. We measured alcohol use with an objective biomarker (phosphatidylethanol [PEth]), comparing individuals (n = 401) with early (CD4 > 350 cells/mL, WHO Stage 1) versus late (CD4 < 200 cells/mL) ART initiation in HIV care in Uganda and South Africa (SA). We examined the association between CD4 count and biomarker results using multivariable regression modeling, and compared PEth results to self-report to assess underreporting. Overall, 32.2{\%} (n = 129) had unhealthy alcohol use (PEth ≥ 50 ng/ml). Early ART initiation was significantly associated with unhealthy alcohol use in Uganda (AOR 2.65; 95{\%} CI: 1.05–6.72), but not SA (AOR 1.00; 95{\%} CI: 0.46–2.17). In Uganda, 23.2{\%} underreported unhealthy alcohol use versus 11.6{\%} in SA (χ2 = 9.30; p < 0.01). Addressing unhealthy alcohol use is important as patients initiate ART earlier, yet challenging due to underreporting.",
keywords = "Alcohol use, Biomarker, HIV treatment, Sub-Saharan Africa",
author = "{the META team} and Magidson, {Jessica F.} and Robin Fatch and Catherine Orrell and Gideon Amanyire and Haberer, {Jessica E.} and Hahn, {Judith A.} and Jessica Haberer and Norma Ware and Bwana, {Mwebesa Bosco} and Asiimwe Stephen and Amanyire Gideon and Tumwesigye Elioda and David Bangsberg and Alex Tsai and Mark Siedner and Lynn Matthews and Ingrid Katz and Monique Wyatt and Nomakhaya April and Alienah Mpahleni and Vivie Situlo and Speech Mzamo and Nomsa Ngwenya and Panda, {Khosi Tshangela Regina} and Teboho Linda and Christine Atwiine and Sheila Moonight and Edna Tindimwebwa and Nicholas Mugisha and Peace Atwogeire and Vian Namana and Catherine Kyampaire and Gabriel Nuwagaba and Annet Kembabazi and Stephen Mugisha and Victoria Nanfuka and Anna Cross and Nicky Kelly and Daphne Moralie and Kate Bell and Nicholas Musinguzi and Dolphina Cogill and Justus Ashaba and Zoleka Xapa and Mathias Orimwesiga and Elly Tuhanamagyezi and Catherine Kyampaire and Mpanga, {Don Bosco} and Leonia Kyarisima and Simone Kigozi",
year = "2018",
month = "1",
day = "1",
doi = "10.1007/s10461-018-2364-2",
language = "English (US)",
journal = "AIDS and Behavior",
issn = "1090-7165",
publisher = "Springer New York",

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TY - JOUR

T1 - Biomarker-Measured Unhealthy Alcohol Use in Relation to CD4 Count Among Individuals Starting ART in Sub-Saharan Africa

AU - the META team

AU - Magidson, Jessica F.

AU - Fatch, Robin

AU - Orrell, Catherine

AU - Amanyire, Gideon

AU - Haberer, Jessica E.

AU - Hahn, Judith A.

AU - Haberer, Jessica

AU - Ware, Norma

AU - Bwana, Mwebesa Bosco

AU - Stephen, Asiimwe

AU - Gideon, Amanyire

AU - Elioda, Tumwesigye

AU - Bangsberg, David

AU - Tsai, Alex

AU - Siedner, Mark

AU - Matthews, Lynn

AU - Katz, Ingrid

AU - Wyatt, Monique

AU - April, Nomakhaya

AU - Mpahleni, Alienah

AU - Situlo, Vivie

AU - Mzamo, Speech

AU - Ngwenya, Nomsa

AU - Panda, Khosi Tshangela Regina

AU - Linda, Teboho

AU - Atwiine, Christine

AU - Moonight, Sheila

AU - Tindimwebwa, Edna

AU - Mugisha, Nicholas

AU - Atwogeire, Peace

AU - Namana, Vian

AU - Kyampaire, Catherine

AU - Nuwagaba, Gabriel

AU - Kembabazi, Annet

AU - Mugisha, Stephen

AU - Nanfuka, Victoria

AU - Cross, Anna

AU - Kelly, Nicky

AU - Moralie, Daphne

AU - Bell, Kate

AU - Musinguzi, Nicholas

AU - Cogill, Dolphina

AU - Ashaba, Justus

AU - Xapa, Zoleka

AU - Orimwesiga, Mathias

AU - Tuhanamagyezi, Elly

AU - Kyampaire, Catherine

AU - Mpanga, Don Bosco

AU - Kyarisima, Leonia

AU - Kigozi, Simone

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Individuals are initiating antiretroviral therapy (ART) at earlier HIV disease stages. Unhealthy alcohol use is a known barrier to successful HIV treatment outcomes, yet it is unclear whether the problem varies by disease stage. We measured alcohol use with an objective biomarker (phosphatidylethanol [PEth]), comparing individuals (n = 401) with early (CD4 > 350 cells/mL, WHO Stage 1) versus late (CD4 < 200 cells/mL) ART initiation in HIV care in Uganda and South Africa (SA). We examined the association between CD4 count and biomarker results using multivariable regression modeling, and compared PEth results to self-report to assess underreporting. Overall, 32.2% (n = 129) had unhealthy alcohol use (PEth ≥ 50 ng/ml). Early ART initiation was significantly associated with unhealthy alcohol use in Uganda (AOR 2.65; 95% CI: 1.05–6.72), but not SA (AOR 1.00; 95% CI: 0.46–2.17). In Uganda, 23.2% underreported unhealthy alcohol use versus 11.6% in SA (χ2 = 9.30; p < 0.01). Addressing unhealthy alcohol use is important as patients initiate ART earlier, yet challenging due to underreporting.

AB - Individuals are initiating antiretroviral therapy (ART) at earlier HIV disease stages. Unhealthy alcohol use is a known barrier to successful HIV treatment outcomes, yet it is unclear whether the problem varies by disease stage. We measured alcohol use with an objective biomarker (phosphatidylethanol [PEth]), comparing individuals (n = 401) with early (CD4 > 350 cells/mL, WHO Stage 1) versus late (CD4 < 200 cells/mL) ART initiation in HIV care in Uganda and South Africa (SA). We examined the association between CD4 count and biomarker results using multivariable regression modeling, and compared PEth results to self-report to assess underreporting. Overall, 32.2% (n = 129) had unhealthy alcohol use (PEth ≥ 50 ng/ml). Early ART initiation was significantly associated with unhealthy alcohol use in Uganda (AOR 2.65; 95% CI: 1.05–6.72), but not SA (AOR 1.00; 95% CI: 0.46–2.17). In Uganda, 23.2% underreported unhealthy alcohol use versus 11.6% in SA (χ2 = 9.30; p < 0.01). Addressing unhealthy alcohol use is important as patients initiate ART earlier, yet challenging due to underreporting.

KW - Alcohol use

KW - Biomarker

KW - HIV treatment

KW - Sub-Saharan Africa

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U2 - 10.1007/s10461-018-2364-2

DO - 10.1007/s10461-018-2364-2

M3 - Article

JO - AIDS and Behavior

JF - AIDS and Behavior

SN - 1090-7165

ER -