Association between Daily Alcohol Use and Increased HIV Viral Load Independent of HAART Adherence

Although prior studies have suggested an association between alcohol use and HIV disease progression, a direct association between alcohol use and HIV biomarkers has not been established. This study examined the relationship between alcohol use and HIV biomarkers independent of highly active antiretroviral therapy (HAART) adherence by comparing HIV viral load and CD4 counts among HIV-infected alcohol users and nonusers in clinical care. Alcohol use and HAART adherence were measured via self-report. Of 325 subjects, 74% were receiving HAART; 11% of those receiving HAART and 24% of those not receiving HAART reported using alcohol daily in the past month.

• Adjusting for HAART adherence and demographic factors, daily drinkers (26 in the HAART group and 20 in the non-HAART group) had a 4-fold increase in the odds of detectable viral load (OR, 3.81) compared with people receiving HAART who did not report daily alcohol use. This relationship was attenuated when people who drank regularly but not daily* (65 people in the HAART group and 20 in the non-HAART group) were included in the analysis.

• A relationship between daily drinking and HIV viral load was not seen among patients who were not receiving HAART.

• No association was noted between alcohol consumption and CD4 count.

Comments:

Although limited by a cross-sectional design and self-reported alcohol and adherence measures, these data are consistent with other studies that suggest an association between daily alcohol consumption and increased HIV viral load for those taking HAART independent of adherence. It remains unclear whether there is a threshold of daily consumption that needs to be exceeded before an effect is seen.

Jeanette M. Tetrault, MD

Reference:

Wu ES, Metzger DS, Lynch KG, et al. Association between alcohol use and HIV viral load. J Acquir Immune Defic Syndr. 2011;56(5):e129–e130.