title: Self-reported alcohol consumption and its association with adherence and outcome of antiretroviral therapy in the Swiss HIV Cohort Study.
abstract: BACKGROUND
  Alcohol consumption leading to morbidity and mortality affects HIV-infected individuals. Here, we aimed to study self-reported alcohol consumption and to determine its association with adherence to antiretroviral therapy (ART) and HIV surrogate markers.
  
  
  METHODS
  Cross-sectional data on daily alcohol consumption from August 2005 to August 2007 were analysed and categorized according to the World Health Organization definition (light, moderate or severe health risk). Multivariate logistic regression models and Pearson's chi(2) statistics were used to test the influence of alcohol use on endpoints.
  
  
  RESULTS
  Of 6,323 individuals, 52.3% consumed alcohol less than once a week in the past 6 months. Alcohol intake was deemed light in 39.9%, moderate in 5.0% and severe in 2.8%. Higher alcohol consumption was significantly associated with older age, less education, injection drug use, being in a drug maintenance programme, psychiatric treatment, hepatitis C virus coinfection and with a longer time since diagnosis of HIV. Lower alcohol consumption was found in males, non-Caucasians, individuals currently on ART and those with more ART experience. In patients on ART (n=4,519), missed doses and alcohol consumption were positively correlated (P<0.001). Severe alcohol consumers, who were pretreated with ART, were more often off treatment despite having CD4+ T-cell count <200 cells/microl; however, severe alcohol consumption per se did not delay starting ART. In treated individuals, alcohol consumption was not associated with worse HIV surrogate markers.
  
  
  CONCLUSIONS
  Higher alcohol consumption in HIV-infected individuals was associated with several psychosocial and demographic factors, non-adherence to ART and, in pretreated individuals, being off treatment despite low CD4+ T-cell counts.
authors.affiliation: Divison of Infectious Diseases and Hospital Epidemiology, University Hospital, Basel, Switzerland.
authors.forename: Anna
authors.initials: A
authors.lastname: Conen
authors.forename: Jan
authors.initials: J
authors.lastname: Fehr
authors.forename: Tracy R
authors.initials: TR
authors.lastname: Glass
authors.forename: Hansjakob
authors.initials: H
authors.lastname: Furrer
authors.forename: Rainer
authors.initials: R
authors.lastname: Weber
authors.forename: Pietro
authors.initials: P
authors.lastname: Vernazza
authors.forename: Bernard
authors.initials: B
authors.lastname: Hirschel
authors.forename: Matthias
authors.initials: M
authors.lastname: Cavassini
authors.forename: Enos
authors.initials: E
authors.lastname: Bernasconi
authors.forename: Heiner C
authors.initials: HC
authors.lastname: Bucher
authors.forename: Manuel
authors.initials: M
authors.lastname: Battegay
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects* / Q000453:epidemiology*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013557:Switzerland / Q000453:epidemiology