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Criticism of response to Alcohol and HIV question

Sep 2, 2003

Hi, Nelson. I'm concerned with your response at The Body web site to the question posted 8/30/2003 as "positive and alcohol use". You cite the Addition Biology article regarding a 220 patient cohort in Miami. I'm concerned, because that cohort was of 220 HIV+ drug users. I cannot get my hands on the original paper (without subscribing to that journal for 280). But I don't know how generalizable that cohort is to the non drug using casual alcohol drinker. Is it worth adding this disclaimer to your response?

David Gelman, MD Poz Magazine medical editor

Posted: Aug 30, 2003

Response from Mr. Vergel

Thanks for bringing this observation up. I agree with you about not generalizing from a HIV drug user to a HIV non drug user population. But I gave the reader the link for them to read the summary which clearly states that it is a drug using population. A moderate comsumption of one to two drinks a day may be have benefits in increasing HDL (good cholesterol levels) But, the reader also said that he gets intoxicated once in a while. Although I do not judge or moralize alcohol use, intoxication may impair judgement (and safe sex practices) and probably adherence to medications. Alcohol also has a dramatic impact on liver function and insulin resistance. So refering a person to any studies in any HIV population that clearly show some impact of alcohol consumption is justified in my point of view as long as the summary can be provided for the person to make their own conclusions.

You may want to check these studies also:

Alcohol consumption and HIV disease progression: are they related? Samet JH, Horton NJ, Traphagen ET, Lyon SM, Freedberg KA. Alcohol Clin Exp Res. 2003 May;27(5):862-7.

Alcohol potentiates HIV-1 infection of human blood mononuclear phagocytes. Wang X, Douglas SD, Metzger DS, Guo CJ, Li Y, O'Brien CP, Song L, Davis-Vogal A, Ho WZ. Alcohol Clin Exp Res. 2002 Dec;26(12):1880-6.

Alcohol use and HIV pharmacotherapy. Kresina TF, Flexner CW, Sinclair J, Correia MA, Stapleton JT, Adeniyi-Jones S, Cargill V, Cheever LW. AIDS Res Hum Retroviruses. 2002 Jul 20;18(11):757-70.

The fatty liver in AIDS. Tien PC, Grunfeld C. Semin Gastrointest Dis. 2002 Jan;13(1):47-54.

Ethanol decreases the efficiency of phosphorylation of thymidine kinase in a human T-lymphocytic cell line. Prakash O, Tang ZY, Zhou P, Peng X, Kolls J, Shellito JE, Nelson S. Alcohol Clin Exp Res. 2002 Mar;26(3):295-302.

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