Alcohol Consumption and CD4 T-Cell Count Response Among Persons Initiating Antiretroviral Therapy
Year: 2012
Type: article
Study design: Observational Study
Abstract: BACKGROUND: We evaluated the longitudinal association of alcohol use with immunologic response to combination antiretroviral therapy (ART) among HIV-infected individuals. METHODS: This was a prospective cohort study of individuals initiating ART. Participants underwent an Audio Computer-Assisted Self-interview querying drug and alcohol use within 6 months of treatment. Immunologic response to ART was defined by CD4 T-cell count (CD4). Primary independent variables were self-reported number of drinks consumed per drinking day (quantity) and days of alcohol consumption in a typical week (frequency). We used linear mixed effects models to quantify the association between CD4 T-cell count and alcohol quantity and frequency and Cox proportional hazards models to estimate the relative hazard of an increase in 100, 150, and 200 CD4 cells per cubic millimeter per additional drink per drinking day. Analyses were stratified by sex. Viral suppression was examined as a time-varying covariate. RESULTS: Between 2000 and 2008, 1107 individuals were eligible for inclusion in this study. There was no statistically significant difference in CD4 T-cell count by average drinks per drinking day at any frequency of alcohol use irrespective of sex or viral suppression. Similarly, we found no difference in the hazard ratio for drinks per drinking day within the categories of drinking frequency for time to CD4 T-cell count increase of 100, 150, and 200 cells per cubic millimeter, respectively. CONCLUSIONS: Among individuals initiating ART, the benefits of therapy and viral suppression on the immune system outweigh detrimental effects of alcohol, reinforcing the importance of initiating ART and ensuring adequate adherence to therapy.
Authors: Stefan Kowalski, Elizabeth Colantuoni, Bryan Lau, Jeanne Keruly, Mary E. McCaul, Heidi E. Hutton, Richard D. Moore, Geetanjali Chander
Institutions: Johns Hopkins University, Johns Hopkins Medicine
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: Alcohol and Psychiatric Comorbidity in HIV+ Women, Alcohol and HIV Treatment and Clinical Progression, Biomarkers, Therapy, and Mortality in the Evolving HIV Epidemic, HIV Disease Outcomes in Drug Users in Clinical Practice, 1/3 Alcohol Research Consortium in HIV - Administrative Core (ARCH-AC), HIV and Substance Abuse, Brief Alcohol Intervention in HIV+ Women, Alcohol and HIV Progression in the Hopkins HIV Cohort, The Johns Hopkins Center for AIDS Research (JHU CFAR), North American AIDS Cohorts on Collaboration and Design (NAACCORD)
OpenAlex ID: W2059757456