Study Links Alcohol Intake to HIV Progression

HIV-infected patients who are drinkers tend to have higher levels of the virus in their blood and lower CD4 counts than similar patients who do not drink, according to a preliminary study. However, this was seen only in patients taking antiretroviral drugs, which suggests that drinkers may be less likely than nondrinkers to take their medication consistently, according to lead author Dr. Jeffrey H. Samet.

"Alcohol is a factor associated with poor adherence," Samet said. However, he stressed that the findings only offered "suggestive evidence that alcohol plays a role in outcomes of people with HIV." "Attention to the alcohol consumption in HIV patients is important for both physicians and patients," said Samet, who is at Boston University.

In the current study, researchers looked at 349 HIV-infected patients with a history of alcohol problems. They found that patients taking antiretroviral drugs who were moderate or problem drinkers had higher levels of HIV in their blood and lower CD4 counts, a sign of immune function.

"Although our results suggest that alcohol use in conjunction with highly active antiretroviral therapy may result in more rapid HIV disease progression... the underlying nature of this association remains unclear," write Samet and colleagues.

One major limitation of the study is that it only looked at patients' viral load and CD4 count on a single day. Such a snapshot is not nearly as good as following patients over time while monitoring adherence to medication and alcohol consumption, explained Samet. Future studies will need to follow patients over time to see whether or not alcohol is associated with adverse HIV outcomes, he noted.

The full report is published in Alcoholism: Clinical and Experimental Research (2003;27:862-867).

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