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Research Summary

Estimating the Impact of Alcohol Use on Survival Among Veterans With HIV

The adverse impact of alcohol use on adherence to antiretroviral therapy (ART) has been repeatedly demonstrated. Alcohol’s effects on survival among individuals with HIV, however, is not clear. Investigators estimated these effects by using a computer simulation model of HIV that incorporated data on drinking and ART adherence from an observational study of 2702 male veterans.

  • Any drinking (versus no drinking) diminished survival (median time until death).
  • As frequency of drinking increased, survival decreased (e.g., drinking 1–4 drinks one or more times per week reduced survival by more than one year; drinking 1–4 drinks daily reduced survival by 3 years).
  • Heavier drinking had the greatest impact on survival (e.g., drinking ≥5 drinks one or more times per week reduced median survival by more than 2 years; drinking ≥5 drinks daily reduced survival by 6 years).

Comments:

An association between mortality and heavier alcohol use among people taking ART is credible and supported in this model. But, the finding of diminished survival with consumption of lesser amounts is unexpected. As these findings are derived from a simulation model based on data from one observational cohort of veterans taking ART, generalization beyond the examined cohort requires caution. 

Jeffrey H. Samet, MD, MA, MPH

Reference:

Braithwaite RS, Conigliaro J, Roberts MS, et al. Estimating the impact of alcohol consumption on survival for HIV+ individuals. AIDS Care. 2007;19(4):459–466.

Disclosure – Dr. Samet is a consultant to the Veterans Aging Cohort Study, which produced data that was used in the above study.


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