Frequent alcohol consumption, alone or combined with crack-cocaine, speeds the progression of HIV through its impact on CD4 cells and its role in preventing patients from taking antiretroviral therapy (ART) consistently, according to a study published last week in AIDS Research and Human Retroviruses.
“These results provide evidence that frequent alcohol use alone, or in combination with crack-cocaine, is a risk factor for accelerated HIV disease progression,” wrote the study authors, “specifically a faster decline of CD4+ cell count and increased HIV viral load.”
Effect of alcohol use on CD4þ cell count
Our study finds that frequent alcohol intake was predictive of a faster decline of CD4þ cells longitudinally in a cohort of active alcohol and drug users, of whom 63–67% reported ART over time. The progression of CD4þ cell decline was independent of ART over time, andwas greater in those who combined frequent alcohol and crack-cocaine use. These results provide evidence that frequent alcohol use alone, or in combination with crack-cocaine, is a risk factor for accelerated HIV disease progression, specifically a faster decline of CD4þ cell count and increased HIV viral load.
This is consistent with findings from a recent report of data from the HIV Alcohol Longitudinal Cohort(ALC) and the HIV Longitudinal Interrelationships of Viruses and Ethanol study (LIVE). This report compared the average difference in HIV disease parameters using generalized linear mixed effects models35 between alcohol users and those who abstained from alcohol, and showed that participants not on ART who were heavy drinkers had CD4þ cell counts that averaged 48.6 cells=ml lower than those who were abstinent.
“These results provide evidence that frequent alcohol use alone, or in combination with crack-cocaine, is a risk factor for accelerated HIV disease progression,” wrote the study authors, “specifically a faster decline of CD4+ cell count and increased HIV viral load.”
Effect of alcohol use on CD4þ cell count
Our study finds that frequent alcohol intake was predictive of a faster decline of CD4þ cells longitudinally in a cohort of active alcohol and drug users, of whom 63–67% reported ART over time. The progression of CD4þ cell decline was independent of ART over time, andwas greater in those who combined frequent alcohol and crack-cocaine use. These results provide evidence that frequent alcohol use alone, or in combination with crack-cocaine, is a risk factor for accelerated HIV disease progression, specifically a faster decline of CD4þ cell count and increased HIV viral load.
This is consistent with findings from a recent report of data from the HIV Alcohol Longitudinal Cohort(ALC) and the HIV Longitudinal Interrelationships of Viruses and Ethanol study (LIVE). This report compared the average difference in HIV disease parameters using generalized linear mixed effects models35 between alcohol users and those who abstained from alcohol, and showed that participants not on ART who were heavy drinkers had CD4þ cell counts that averaged 48.6 cells=ml lower than those who were abstinent.
Similar to our findings, the above study found no impact of heavy alcohol use on HIV viral load in those not on ART, leading the authors to suggest that the decrement in CD4þ cell count was not mediated by increased viral load, rather it was related to a direct effect of alcohol on CD4þ cells or lymphocytes in general. They suggested that the large beneficial effect of ART onCD4þ cell countmay make it difficult to see a moderate effect of heavy alcohol intake on CD4þ cell count.
The 30-month study followed HIV-positive adults with histories of alcohol and illegal drug use. The study found that those who had more than two drinks daily were almost three times more likely to see a significant drop in CD4 cells, independent of other factors including ART adherence. According to the study’s author’s, alcohol may directly influence disease progression by affecting these cells and the immune system, which is consistent with previous studies showing alcohol’s immune suppressant effects.
Despite conflicting results among existing studies about the effects of alcohol on HIV disease progression, experts encourage people with HIV to avoid recreational drug use and heavy drinking to minimize immune system damage.
DOWNLOAD THE FULL STUDY HERE IN PDF
Peace and Tolerance
H
The 30-month study followed HIV-positive adults with histories of alcohol and illegal drug use. The study found that those who had more than two drinks daily were almost three times more likely to see a significant drop in CD4 cells, independent of other factors including ART adherence. According to the study’s author’s, alcohol may directly influence disease progression by affecting these cells and the immune system, which is consistent with previous studies showing alcohol’s immune suppressant effects.
Despite conflicting results among existing studies about the effects of alcohol on HIV disease progression, experts encourage people with HIV to avoid recreational drug use and heavy drinking to minimize immune system damage.
DOWNLOAD THE FULL STUDY HERE IN PDF
Peace and Tolerance
H
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