TY - JOUR
T1 - The influence of different types of alcoholic beverages on disrupting highly active antiretroviral treatment (HAART) outcome
AU - Míguez-Burbano, María José
AU - Lewis, John E.
AU - Fishman, Joel
AU - Asthana, Deshratn
AU - Malow, Robert M.
N1 - Funding Information:
Acknowledgements — The authors thank Rhonda Rosenberg for critical reading of the manuscript and for expert editorial assistance. The study was funded by the NIAAA of the United States (5R21AA13793-3 and 3R01AA017405-02S1 M.J.M.).
PY - 2009
Y1 - 2009
N2 - Aims: Studies have yielded conflicting results regarding alcohol's influence on HIV outcomes, particularly after highly active antiretroviral treatment (HAART). Discrepant findings may be related to confounding variables, including gender, patterns of alcohol abuse and type of alcohol beverage beyond the amount consumed. Methods: Using a cohort study, differences in HAART effectiveness after 24 weeks of therapy were compared as a function of amount and preference for alcohol, drinking only liquor (LI, n = 55) or only wine or beer (BW, n = 110). Given the critical role of thymus on HAART response, changes in thymus size, CD4s, naïve lymphocytes and viral loads were assessed. Results: After HAART, positive increases in both CD4s (+12 cell counts/mm3) and thymus size (+0.7 mm3) were evident in the BW group. In contrast, the LI subgroup exhibited a decline in both parameters (-4 CD4 cells/mm3 and -0.6 mm3 in thymus size). Women in the LI group exhibited significantly lower CD4 (163.4 ± 46.2) and naïve counts (178 ± 69.5) than LI men (CD4: 281.6 ± 203, P = 0.05; lymphocytes: 301.4 ± 198, P = 0.04). In adjusted regression models, the LI compared to the BW subgroup had greater odds of maintaining detectable viral loads (RR = 1.35, 95% CI 1.04-1.75; P = 0.03), increased thymus volumes (RR = 3.8, P = 0.04) and replenished naïve cells (RR = 13, P = 0.02). Conclusions: Liquor was associated with thymus deterioration and thus with poorer viro-immune outcomes after HAART. Subtyping participants by alcohol consumption patterns seems to be clinically relevant and needs to be accounted for in future studies.
AB - Aims: Studies have yielded conflicting results regarding alcohol's influence on HIV outcomes, particularly after highly active antiretroviral treatment (HAART). Discrepant findings may be related to confounding variables, including gender, patterns of alcohol abuse and type of alcohol beverage beyond the amount consumed. Methods: Using a cohort study, differences in HAART effectiveness after 24 weeks of therapy were compared as a function of amount and preference for alcohol, drinking only liquor (LI, n = 55) or only wine or beer (BW, n = 110). Given the critical role of thymus on HAART response, changes in thymus size, CD4s, naïve lymphocytes and viral loads were assessed. Results: After HAART, positive increases in both CD4s (+12 cell counts/mm3) and thymus size (+0.7 mm3) were evident in the BW group. In contrast, the LI subgroup exhibited a decline in both parameters (-4 CD4 cells/mm3 and -0.6 mm3 in thymus size). Women in the LI group exhibited significantly lower CD4 (163.4 ± 46.2) and naïve counts (178 ± 69.5) than LI men (CD4: 281.6 ± 203, P = 0.05; lymphocytes: 301.4 ± 198, P = 0.04). In adjusted regression models, the LI compared to the BW subgroup had greater odds of maintaining detectable viral loads (RR = 1.35, 95% CI 1.04-1.75; P = 0.03), increased thymus volumes (RR = 3.8, P = 0.04) and replenished naïve cells (RR = 13, P = 0.02). Conclusions: Liquor was associated with thymus deterioration and thus with poorer viro-immune outcomes after HAART. Subtyping participants by alcohol consumption patterns seems to be clinically relevant and needs to be accounted for in future studies.
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U2 - 10.1093/alcalc/agp024
DO - 10.1093/alcalc/agp024
M3 - Article
C2 - 19454401
AN - SCOPUS:67650233331
VL - 44
SP - 366
EP - 371
JO - Alcohol and Alcoholism
JF - Alcohol and Alcoholism
SN - 0735-0414
IS - 4
ER -