Patients
who drank while taking the drugs had higher levels of the virus and lower
levels of the immune cells that rally the body’s defenses
against the virus, Jeffrey H. Samet, M.D., M.A., M.P.H., of Boston Medical
Center and
colleagues report in the journal Alcoholism: Clinical and Experimental
Research.
The researchers found no connection between alcohol consumption and the progression
of HIV in patients who were not taking antiretroviral medications.
Samet and colleagues are uncertain why the combination seems
to speed up HIV’s
advance, “but a leading potential explanation for our findings is that
alcohol use decreases adherence to HIV medications.” Alcohol and the
antiretrovirals may also combine to have harmful effects on the liver or
immune system, they say.
The study examined HIV progression in 349 Boston-area patients
who had a history of alcohol problems. Over half of the patients were men
who had contracted
the disease through injection drug use. The men were classified as current
moderate or “at-risk” drinkers, the latter if they had more than
14 drinks a week. The threshold for women was seven drinks a week.
Moderate and at-risk drinkers both had lower CD4 white blood cell counts and
higher levels of HIV than patients who did not drink. The combination of low
CD4 counts and high virus amount indicates that an infection is growing worse,
say the researchers.
Previous studies suggest that there may be high rates of alcohol abuse among
patients with HIV, making it an important issue to address before beginning
or continuing antiretroviral treatment, Samet and colleagues conclude.
