Alcohol and HIV Disease Progression: Is Liquor Quicker (than Beer and Wine)?
Alcohol affects the course of HIV disease, but the mechanisms of this effect (i.e., individual susceptibility and the importance of the type of alcohol) are poorly understood. Miguez-Burbano and colleagues studied differences in antiretroviral (ART) effectiveness after 24 weeks of therapy as a function of alcohol type consumed, comparing only liquor (LI, n=55) with only beer or wine (BW, n=110). Outcome measures were CD4 cell count, thymus size (by MRI), naïve lymphocytes, and HIV viral load (HVL). Comparisons were controlled in multivariable analyses for potential confounders including gender, race/ethnicity, HIV status (per CDC criteria), drug use, and body mass index. Alcohol was consumed on a similar number of days by both groups but in higher quantity in the LI group, which also had a higher baseline HVL. The following differences were noted:
- CD4 increased in the BW group (+12 cells/mm3) compared with the LI group (-4 cells/mm3).
- thymus volume increased in the BW group compared with the LI group (p=0.05).
- an increase of at least 50 CD4 cells immediately after ART initiation (a good prognostic indicator) was more commonly achieved in the BW group (50%) than in the LI group (10%).