title: The influence of different types of alcoholic beverages on disrupting highly active antiretroviral treatment (HAART) outcome.
abstract: 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.
authors.affiliation: Florida International University, 13313 Kingsbury Drive, Wellington, FL 33414, USA. mjmiguez1163@bellsouth.net
authors.forename: María José
authors.initials: MJ
authors.lastname: Míguez-Burbano
authors.forename: John E
authors.initials: JE
authors.lastname: Lewis
authors.forename: Joel
authors.initials: J
authors.lastname: Fishman
authors.forename: Deshratn
authors.initials: D
authors.lastname: Asthana
authors.forename: Robert M
authors.initials: RM
authors.lastname: Malow
mesh_terms: 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