The influence of different types of alcoholic beverages on disrupting highly active antiretroviral treatment (HAART) outcome.
OBJECTIVE
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/mm(3)) and thymus size (+0.7 mm(3)) were evident in the BW group. In contrast, the LI subgroup exhibited a decline in both parameters (-4 CD4 cells/mm(3) and -0.6 mm(3) 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.
Míguez-Burbano
María José
MJ
Florida International University, 13313 Kingsbury Drive, Wellington, FL 33414, USA. mjmiguez1163@bellsouth.net
Lewis
John E
JE
Fishman
Joel
J
Asthana
Deshratn
D
Malow
Robert M
RM
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000428:Alcohol Drinking / Q000009:adverse effects* / Q000453:epidemiology; D000434:Alcoholic Beverages / Q000009:adverse effects*; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D005006:Ethnicity; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007109:Immunity / Q000235:genetics; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D013950:Thymus Gland / Q000473:pathology; D016896:Treatment Outcome; D055815:Young Adult