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Alcohol/Smoking Effects on HIV
Aug 21, 2000

When other professionals are too busy, or have just become a little calloused to OUR need, thank God you are still there, explaining and giving advice that we understand. I've received more info from this site than my doc in 5 years. Thanks so much. I know and have heard from health care professionals that if you are HIV-infected you should not smoke or drink alcohol. However, I read that many HIV patients do just that. Now, I also like a drink now and then, and light one up too. But, I'm afraid, because I don't actually know what it's doing to my body in relation to the HIV. I know that smoking and drinking is bad health, but what effects does it have on HIV and how? What does it do? How serious is it to treatment? Thanks, Andrew

Response from Dr. Cohen

Hey Andrew. Thanks for the compliment about the site - although sounds like you need a better relationship with your own provider...?

As for cigs and alcohol -- we have no specific link of tobacco smoke to HIV replication. As you mention, there are PLENTY of health reasons to not smoke -- including needing good healthy lungs to fight off normal infections, which can only be harder for someone who has HIV. And there are theoretical reasons why smoking would be a bad idea involving the depletion of antioxidants at the cellular level by tobacco, and indirectly allowing HIV to cause more cellular harm since the harm from HIV may involve some of these same pathways. There is likely an important difference in those who smoke an occasional cig once or twice on weekends with a drink versus those who smoke regularly however -- but many find tobacco more addictive than this and don't stop at the one or two now and then...

As for alcohol -- in small amounts it likely does little harm. More than a small amount can be a problem of course -- leading to problems like pancreatitis for those who binge drink, and chronic liver problems for those who drink a lot regularly. Both of these can be complex for anyone with HIV. And some antivirals might particularly interact with alcohol -- and all of them need a healthy liver. But the occasional drink -- whether it be Bud, Cabernet, or Absolut, appears to be a reasonable indulgence for those who indulge.

Hope that clarifies. Cheers.

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