Alcohol and Alcoholism Advance Access published online on May 18, 2009
Alcohol and Alcoholism, doi:10.1093/alcalc/agp024
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Published by Oxford University Press on behalf of the Medical Council on Alcohol 2009
The Influence of Different Types of Alcoholic Beverages on Disrupting HAART Outcome
1 Department of Public Health, Florida International University, Miami, FL, USA
2 Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
3 Department of Radiology, University of Miami Miller School of Medicine, Miami, FL, USA
* Corresponding Author: Florida International University, 13313 Kingsbury Drive, Wellington, FL 33414, USA. Tel: +1-561-422-3610; Fax: +1-561-422-3610; E-mail: mjmiguez1163{at}bellsouth.net
Received 3 November 2008; ; accepted 2 April 2009
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Abstract |
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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.