Alcohol Does Not Worsen Disease Progression or Impair Treatment for People with HIV

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People with HIV who consume alcohol did not see detrimental changes in their CD4 T-cell count or viral load when compared with non-drinkers, though those who drank heavily had more difficulty achieving good treatment adherence, researchers reported in the July 25, 2013, advance edition of the Journal of Acquired Immune Deficiency Syndromes.

Healthcare providers generally recommend moderate alcohol consumption or abstinence, but there is conflicting data about the effects of drinking on HIV disease progression and response to antiretroviral therapy (ART).

Anna Conen and fellow investigators with the Swiss HIV Cohort Study looked at the association between self-reported alcohol consumption and surrogate markers of HIV disease progression in both treated and untreated individuals.

This prospective cohort study included approximately 5000 participants in the Swiss HIV Cohort Study -- a long-term observational study of people with HIV throughout Switzerland -- who received care between 2005 and 2012. A majority were men, most were white, and men who have sex with men was the most common transmission risk category. 

The analysis included 2982 participants who started ART for the first time and 2085 people who did not start treatment. They were categorized as light, moderate, or severe drinkers in terms of health risk. Approximately 55% reported that they sometimes drank alcohol, but only 2% were classified as consuming enough to constitute a severe health risk (40 g for women or 60 g for men per week).

Results

"No effect of alcohol consumption on either virological failure or CD4 cell count in both groups of ART initiating and naive individuals was found," the researchers concluded. However, they added, "severe drinkers were more likely to interrupt ART."

"Efforts [related to] ART continuation should be especially implemented in individuals reporting high alcohol consumption," they recommended. But as heavy drinkers were not shown to have a higher risk of virological failure, "ART should not be withheld" from these individuals.

8/21/13

Reference

A Conen, Q Wang, CA Fux, et al. Association of alcohol consumption and HIV surrogate markers in participants of the Swiss HIV Cohort Study. Journal of Acquired Immune Deficiency Syndromes. July 25, 2013 (Epub ahead of print).