Researchers from Boston University School of Medicine (BUSM) have found a link between alcohol consumption and HIV disease progression in HIV-infected persons. The study appears online in the August issue of the Journal of Acquired Immune Deficiency Syndromes.
Alcohol use is common among HIV-infected persons, and its impact on HIV disease progression has been examined in in-vitro, animal and human studies. Alcohol may adversely affect immunologic function in HIV-infected persons by various mechanisms, including increased HIV replication in lymphocytes.
Researchers assessed CD4 cell counts, HIV RNA levels [viral load], and alcohol consumption in 595 HIV-infected persons with alcohol problems. The relation of HIV disease progression to alcohol consumption was studied using longitudinal regression models controlling for known prognostic factors, including adherence and depressive symptoms, and stratified by antiretroviral therapy (ART) use. Among subjects who were not on ART, heavy alcohol consumption was associated with a lower CD4 cell count. Among subjects who were on ART, heavy alcohol consumption was not associated with a lower CD4 cell count or higher HIV viral load. “
Alcohol use in patients with a prevalent disease such as HIV, can have important public health consequences,” said lead author Jeffrey Samet, MD, MPH, a professor of medicine at BUSM and chief of General Internal Medicine at Boston Medical Center. “HIV-infected persons who drink alcohol heavily and are not on ART might decrease their risk of disease progression if they abstain from alcohol use.”
Researchers further noted that there is extensive evidence about the efficacy of a brief intervention for unhealthy alcohol use in nondependent drinkers in medical settings and of the efficacy of psychosocial and pharmacologic treatments for alcohol dependence. “Although limited evidence demonstrates the effectiveness of intervention for alcohol problems specifically in people with HIV, its implementation among HIV-infected populations seems to be a worthwhile goal,” according to senior author Richard Saitz, MD, MPH, professor of medicine at BUSM, director of the Clinical Addiction Research and Education Unit at Boston Medical Center, and associate director of the Boston University School of Public Health Youth Alcohol Prevention Center.