Validating Self-Reported Unhealthy Alcohol Use With Phosphatidylethanol (PEth) Among Patients With HIV

Oghenowede Eyawo, Yanhong Deng, James Dziura, Amy C. Justice, Kathleen McGinnis, Janet P. Tate, Maria C. Rodriguez-Barradas, Nathan B. Hansen, Stephen A. Maisto, Vincent C. Marconi, Patrick G. O’Connor, Kendall Bryant, David A. Fiellin, E. Jennifer Edelman

Research output: Contribution to journalArticle

Abstract

Background: We sought to compare self-reported alcohol consumption using Timeline Followback (TLFB) to biomarker-based evidence of significant alcohol use (phosphatidylethanol [PEth] > 20 ng/ml). Using data from patients with HIV (PWH) entering a clinical trial, we asked whether TLFB could predict PEth > 20 ng/ml and assessed the magnitude of association between TLFB and PEth level. Methods: We defined unhealthy alcohol use as any alcohol use in the presence of liver disease, at-risk drinking, or alcohol use disorder. Self-reported alcohol use obtained from TLFB interview was assessed as mean number of drinks/day and number of heavy drinking days over the past 21 days. Dried blood spot samples for PEth were collected at the interview. We used logistic regression to predict PEth > 20 ng/ml and Spearman correlation to quantify the association with PEth, both as a function of TLFB. Results: Among 282 individuals (99% men) in the analytic sample, approximately two-thirds (69%) of individuals had PEth > 20 ng/ml. The proportion with PEth > 20 ng/ml increased with increasing levels of self-reported alcohol use; of the 190 patients with either at-risk drinking or alcohol use disorder based on self-report, 82% had PEth > 20 ng/ml. Discrimination was better with number of drinks per day than heavy drinking days (AUC: 0.80 [95% CI: 0.74 to 0.85] vs. 0.74 [95% CI: 0.68 to 0.80]). The number of drinks per day and PEth were significantly and positively correlated across all levels of alcohol use (Spearman’s R ranged from 0.29 to 0.56, all p values < 0.01). Conclusions: In this sample of PWH entering a clinical trial, mean numbers of drinks per day discriminated individuals with evidence of significant alcohol use by PEth. PEth complements self-report to improve identification of self-reported unhealthy alcohol use among PWH.

Original languageEnglish (US)
Pages (from-to)2053-2063
Number of pages11
JournalAlcoholism: Clinical and Experimental Research
Volume44
Issue number10
DOIs
StatePublished - Oct 1 2020

Keywords

  • Alcohol Use
  • Biomarker
  • HIV
  • PEth
  • Phosphatidylethanol
  • TLFB
  • Timeline Followback

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Toxicology
  • Psychiatry and Mental health

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