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We investigated whether the association between alcohol use and mortality among PWH is modified by HCV. Data were combined from European and North American cohorts of adult PWH who started antiretroviral therapy (ART). Self\u2010reported alcohol use data, collected in diverse ways between cohorts, were converted to grams\/day. Eligible PWH started ART during 2001\u20132017 and were followed from ART initiation for mortality. Interactions between the associations of baseline alcohol use (0, 0.1\u201320.0, &gt;20.0 g\/day) and HCV status were assessed using multivariable Cox models. Of 58,769 PWH, 29,711 (51%), 23,974 (41%) and 5084 (9%) self\u2010reported alcohol use of 0\u2009g\/day, 0.1\u201320.0\u2009g\/day, and\u2009&gt;\u200920.0\u2009g\/day, respectively, and 4799 (8%) had HCV at baseline. There were 844 deaths in 37,729 person\u2010years and 2755 deaths in 443,121 person\u2010years among those with and without HCV, respectively. Among PWH without HCV, adjusted hazard ratios (aHRs) for mortality were 1.18 (95% CI: 1.08\u20131.29) for 0.0\u2009g\/day and 1.84 (1.62\u20132.09) for &gt;20.0\u2009g\/day compared with 0.1\u201320.0\u2009g\/day. This J\u2010shaped pattern was absent among those with HCV: aHRs were 1.00 (0.86\u20131.17) for 0.0\u2009g\/day and 1.64 (1.33\u20132.02) for &gt;20.0\u2009g\/day compared with 0.1\u201320.0\u2009g\/day (interaction <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). Among PWH without HCV, mortality was higher in both non\u2010drinkers and heavy drinkers compared with moderate alcohol drinkers. Among those with HCV, mortality was higher in heavy drinkers but not non\u2010drinkers, potentially due to differing reasons for not drinking (e.g. illness) between those with and without HCV.<\/jats:p>","DOI":"10.1111\/jvh.13863","type":"journal-article","created":{"date-parts":[[2023,6,20]],"date-time":"2023-06-20T11:07:10Z","timestamp":1687259230000},"page":"775-786","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Contribution of alcohol use in <scp>HIV<\/scp>\/hepatitis C virus co\u2010infection to all\u2010cause and cause\u2010specific mortality: A collaboration of cohort studies"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3462-2898","authenticated-orcid":false,"given":"Adam","family":"Trickey","sequence":"first","affiliation":[{"name":"Population Health Sciences University of Bristol  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne M.","family":"Ingle","sequence":"additional","affiliation":[{"name":"Population Health Sciences University of Bristol  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Boyd","sequence":"additional","affiliation":[{"name":"Stichting HIV Monitoring  Amsterdam The Netherlands"},{"name":"Department of Infectious Diseases Public Health Service of Amsterdam  Amsterdam The Netherlands"},{"name":"Amsterdam UMC University of Amsterdam, Infectious Diseases  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. John","family":"Gill","sequence":"additional","affiliation":[{"name":"South Alberta HIV Clinic, Department of Medicine University of Calgary  Calgary Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Grabar","sequence":"additional","affiliation":[{"name":"Sorbonne Universit\u00e9, INSERM, Institut Pierre Louis d'\u00c9pid\u00e9miologie et de Sant\u00e9 Publique (IPLESP)  Paris France"},{"name":"Department of Public Health AP\u2010HP, St Antoine Hospital  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inma","family":"Jarrin","sequence":"additional","affiliation":[{"name":"National Centre of Epidemiology Carlos III Health Institute  Madrid Spain"},{"name":"CIBER de Enfermedades Infecciosas Instituto de Salud Carlos III"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niels","family":"Obel","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Copenhagen University Hospital, Rigshospitalet  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giota","family":"Touloumi","sequence":"additional","affiliation":[{"name":"Department of Hygiene, Epidemiology and Medical Statistics, Medical School National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Zangerle","sequence":"additional","affiliation":[{"name":"Austrian HIV Cohort Study (AHIVCOS) Medizinische Universit\u00e4t Innsbruck  Innsbruch Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5297-6062","authenticated-orcid":false,"given":"Andri","family":"Rauch","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Inselspital Bern University Hospital, University of Bern  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher T.","family":"Rentsch","sequence":"additional","affiliation":[{"name":"Yale School of Medicine and VA Connecticut Healthcare System  West Haven Connecticut USA"},{"name":"Faculty of Epidemiology and Population Health London School of Hygiene and Tropical Medicine  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derek D.","family":"Satre","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Weill Institute for Neurosciences, University of California  San Francisco USA"},{"name":"Division of Research Kaiser Permanente Northern California  Oakland California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Silverberg","sequence":"additional","affiliation":[{"name":"Division of Research Kaiser Permanente Northern California  Oakland California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrice","family":"Bonnet","sequence":"additional","affiliation":[{"name":"Institut Bergoni\u00e9, BPH, U1219, CIC\u2010EC 1401, INSERM, Univ. Bordeaux  Bordeaux France"},{"name":"CHU de Bordeaux, Service de M\u00e9decine Interne et Maladies Infectieuses, INSERM Institut Bergoni\u00e9 H\u00f4pital St\u2010Andr\u00e9, CIC\u2010EC 1401  Bordeaux France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jodie","family":"Guest","sequence":"additional","affiliation":[{"name":"Atlanta VA Medical Center  Decatur Georgia USA"},{"name":"Rollins School of Public Health at Emory University  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greer","family":"Burkholder","sequence":"additional","affiliation":[{"name":"University of Alabama  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi","family":"Crane","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramon","family":"Teira","sequence":"additional","affiliation":[{"name":"Servicio de Medicina Interna Hospital Universitario de Sierrallana  Torrelavega Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8541-8200","authenticated-orcid":false,"given":"Juan","family":"Berenguer","sequence":"additional","affiliation":[{"name":"Hospital General Universitario Gregorio Mara\u00f1\u00f3n  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Wyen","sequence":"additional","affiliation":[{"name":"Department I for Internal Medicine University Hospital of Cologne  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Abgrall","sequence":"additional","affiliation":[{"name":"APHP, Service de M\u00e9decine Interne, H\u00f4pital B\u00e9cl\u00e8re  Clamart France"},{"name":"CESP, INSERM U1018, Universit\u00e9 Paris\u2010Saclay, UVSQ, Le Kremlin\u2010Bic\u00eatre  Villejuif France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mojgan","family":"Hessamfar","sequence":"additional","affiliation":[{"name":"Institut Bergoni\u00e9, BPH, U1219, CIC\u2010EC 1401, INSERM, Univ. 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C.","family":"Sterne","sequence":"additional","affiliation":[{"name":"Population Health Sciences University of Bristol  Bristol UK"},{"name":"NIHR Bristol Biomedical Research Centre  Bristol UK"},{"name":"Health Data Research UK South\u2010West  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Wittkop","sequence":"additional","affiliation":[{"name":"Institut Bergoni\u00e9, BPH, U1219, CIC\u2010EC 1401, INSERM, Univ. 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