title: Alcohol and HIV disease progression: weighing the evidence.
abstract: Heavy alcohol use is commonplace among HIV-infected individuals; however, the extent that alcohol use adversely impacts HIV disease progression has not been fully elucidated. Fairly strong evidence suggests that heavy alcohol consumption results in behavioral and biological processes that likely increase HIV disease progression, and experimental evidence of the biological effect of heavy alcohol on simian immunodeficiency virus in macaques is quite suggestive. However, several observational studies of the effect of heavy alcohol consumption on HIV progression conducted in the 1990s found no association of heavy alcohol consumption with time to AIDS diagnosis, while some more recent studies showed associations of heavy alcohol consumption with declines of CD4 cell counts and nonsuppression of HIV viral load. We discuss several plausible biological and behavioral mechanisms by which alcohol may cause HIV disease progression, evidence from prospective observational human studies, and suggest future research to further illuminate this important issue.
authors.affiliation: Division of Infectious Diseases, Department of Medicine, San Francisco General Hospital, University of California-San Francisco, San Francisco, CA 94143-0811, USA. judy.hahn@ucsf.edu
authors.forename: Judith A
authors.initials: JA
authors.lastname: Hahn
authors.forename: Jeffrey H
authors.initials: JH
authors.lastname: Samet
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000276:immunology / Q000503:physiopathology* / Q000821:virology; D000428:Alcohol Drinking; D000437:Alcoholism / Q000150:complications*; D019380:Anti-HIV Agents / Q000627:therapeutic use; D016739:Behavior, Addictive; D018791:CD4 Lymphocyte Count; D018450:Disease Progression; D004198:Disease Susceptibility; D006678:HIV / Q000502:physiology; D015658:HIV Infections / Q000188:drug therapy / Q000276:immunology / Q000503:physiopathology* / Q000821:virology; D015438:Health Behavior; D006801:Humans; D008107:Liver Diseases / Q000150:complications; D044342:Malnutrition / Q000150:complications; D010349:Patient Compliance; D012309:Risk-Taking; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents
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