TY - JOUR
T1 - Alcohol consumption and CD4 T-cell count response among persons initiating antiretroviral therapy
AU - Kowalski, Stefan
AU - Colantuoni, Elizabeth
AU - Lau, Bryan
AU - Keruly, Jeanne
AU - McCaul, Mary E.
AU - Hutton, Heidi E.
AU - Moore, Richard D.
AU - Chander, Geetanjali
PY - 2012/12/1
Y1 - 2012/12/1
N2 - BACKGROUND: We evaluated the longitudinal association of alcohol use with immunologic response to combination antiretroviral therapy (ART) among HIV-infected individuals. METHODS: This was a prospective cohort study of individuals initiating ART. Participants underwent an Audio Computer-Assisted Self-interview querying drug and alcohol use within 6 months of treatment. Immunologic response to ART was defined by CD4 T-cell count (CD4). Primary independent variables were self-reported number of drinks consumed per drinking day (quantity) and days of alcohol consumption in a typical week (frequency). We used linear mixed effects models to quantify the association between CD4 T-cell count and alcohol quantity and frequency and Cox proportional hazards models to estimate the relative hazard of an increase in 100, 150, and 200 CD4 cells per cubic millimeter per additional drink per drinking day. Analyses were stratified by sex. Viral suppression was examined as a time-varying covariate. RESULTS: Between 2000 and 2008, 1107 individuals were eligible for inclusion in this study. There was no statistically significant difference in CD4 T-cell count by average drinks per drinking day at any frequency of alcohol use irrespective of sex or viral suppression. Similarly, we found no difference in the hazard ratio for drinks per drinking day within the categories of drinking frequency for time to CD4 T-cell count increase of 100, 150, and 200 cells per cubic millimeter, respectively. CONCLUSIONS: Among individuals initiating ART, the benefits of therapy and viral suppression on the immune system outweigh detrimental effects of alcohol, reinforcing the importance of initiating ART and ensuring adequate adherence to therapy.
AB - BACKGROUND: We evaluated the longitudinal association of alcohol use with immunologic response to combination antiretroviral therapy (ART) among HIV-infected individuals. METHODS: This was a prospective cohort study of individuals initiating ART. Participants underwent an Audio Computer-Assisted Self-interview querying drug and alcohol use within 6 months of treatment. Immunologic response to ART was defined by CD4 T-cell count (CD4). Primary independent variables were self-reported number of drinks consumed per drinking day (quantity) and days of alcohol consumption in a typical week (frequency). We used linear mixed effects models to quantify the association between CD4 T-cell count and alcohol quantity and frequency and Cox proportional hazards models to estimate the relative hazard of an increase in 100, 150, and 200 CD4 cells per cubic millimeter per additional drink per drinking day. Analyses were stratified by sex. Viral suppression was examined as a time-varying covariate. RESULTS: Between 2000 and 2008, 1107 individuals were eligible for inclusion in this study. There was no statistically significant difference in CD4 T-cell count by average drinks per drinking day at any frequency of alcohol use irrespective of sex or viral suppression. Similarly, we found no difference in the hazard ratio for drinks per drinking day within the categories of drinking frequency for time to CD4 T-cell count increase of 100, 150, and 200 cells per cubic millimeter, respectively. CONCLUSIONS: Among individuals initiating ART, the benefits of therapy and viral suppression on the immune system outweigh detrimental effects of alcohol, reinforcing the importance of initiating ART and ensuring adequate adherence to therapy.
KW - CD4 T-cell count
KW - HIV
KW - alcohol
KW - antiretroviral therapy
KW - immune response
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U2 - 10.1097/QAI.0b013e3182712d39
DO - 10.1097/QAI.0b013e3182712d39
M3 - Article
C2 - 22955054
AN - SCOPUS:84870300856
SN - 1525-4135
VL - 61
SP - 455
EP - 461
JO - Journal of Acquired Immune Deficiency Syndromes
JF - Journal of Acquired Immune Deficiency Syndromes
IS - 4
ER -