HAB HIV Core Clinical Performance Measures for 

Adult/Adolescent Clients: Group 3

Final: April 2009  Page 7 

Performance Measure: Hepatitis/HIV Alcohol Counseling OPR-Related Measure: No 

Percentage of clients1 with HIV and Hepatitis B (HBV) or Hepatitis C (HCV) infection who received alcohol 

counseling2

 within the measurement year 

Numerator: Number of HIV-infected clients who received alcohol counseling 

Denominator: 

Number of HIV-infected clients who: 

 were co-infected with HBV3 or HCV; and 

 had a medical visit with a provider with prescribing privileges4 at least once in the 

measurement period 

Patient 

Exclusions: None 

Data Elements: 

1. Is the client HIV-infected? (Y/N) 

a. If yes, is the client HBV or HCV-positive? (Y/N) 

i. If yes, did the client receive alcohol counseling during the 

measurement year? (Y/N) 

Data Sources: 

 Electronic Medical Record/Electronic Health Record 

 CAREWare, Lab Tracker, or other electronic data base 

 Medical record data abstraction by grantee of a sample of records 

 Billing records 

National Goals, 

Targets, or 

Benchmarks 

for 

Comparison 

None available at this time. 

Outcome 

Measures for 

Consideration: 

 Hepatitis-related mortality rates in the clinic population 

Basis for Selection and Placement in Group 3: 

Discussion of substance use allows the clinician to either provide counseling or make referrals to substance 

and alcohol treatment centers. A study of HIV positive veterans showed that hazardous drinking and alcohol 

diagnoses were associated with HIV disease progression and/or hepatic co-morbidity and anemia. It also 

concluded that alcohol problems are often missed by providers thus increasing the need for routine 

screening.5 

Long-term studies of patients with chronic HCV infection show that between 2%-20% develop cirrhosis in 20 

years. This rate of progression increases with older age, alcoholism and HIV infection.6 

The measure is placed in Group 3 because the definition of “counseling” varies considerably across grantees. 
HAB HIV Core Clinical Performance Measures for 

Adult/Adolescent Clients: Group 3

Final: April 2009  Page 8 

The variation in definition impacts the feasibility of data collection. 

US Public Health Guidelines: 

“All patients with HIV/HCV infection should be advised to avoid or limit alcohol consumption...”7

References/Notes:

1 “Clients” refers to all clients aged 13 years and older. 

2

 For the purposes of this measure, alcohol counseling refers to counseling provided by the primary care team 

that emphasizes the need to avoid or limit alcohol intake due to the impact on the liver. 

3 Markers of Hepatitis B infection include Hep B Surface Antigen, Hep B e Antigen, Hep B e Antibody or 

Hep B DNA. 

4

A “provider with prescribing privileges” is a health care professional who is certified in their jurisdiction to 

prescribe medications. 

5

 Joseph Conigliaro, Adam J. Gordon, Kathleen A. McGinnis, Linda Rabeneck, and Amy C.; How Harmful Is 

Hazardous Alcohol Use and Abuse in HIV Infection: Do Health Care Providers Know Who Is at Risk?; 

Journal of Acquired Immune Deficiency Syndromes 33:521–525. 

6

 Centers for Disease Control and Prevention. Guidelines for Prevention and Treatment of Opportunistic 

Infections in HIV-Infected Adults and Adolescents. June 18, 2008; 1-134. 

(http://aidsinfo.nih.gov/contentfiles/Adult_OI.pdf)