title: Untreated HIV infection is associated with higher blood alcohol levels.
abstract: BACKGROUND
  Alcohol abuse has been associated with HIV/AIDS progression, but the effects of HIV infection and treatment on alcohol exposure have not been explored to date. This pilot study examines the relationship of untreated HIV infection to blood alcohol concentrations (BAC) relative to BAC after initiation of antiretroviral therapy (ART).
  
  
  METHODS
  Fifteen volunteers with untreated HIV/AIDS participated in 2 sets of alcohol or alcohol placebo administration studies before and after initiation of ART. Oral alcohol (1 g/kg) or alcohol placebo was administered, participants were followed for pharmacokinetics, subjective responses, and cognitive effects over 8 hours. After initial alcohol studies, the ART regimen selected by participant clinicians was instituted. Observed ART dosing took place for at least 2 weeks. Participants then returned for a second set of alcohol/placebo administration studies while on ART.
  
  
  RESULTS
  Participants had significantly higher BAC (P < 0.001) before ART than after ART administration. Alcohol area under the curve was significantly higher in untreated HIV disease (P = 0.011) with significantly higher C(max) (P = 0.015) and C(min) (P = 0.05). The elimination rate was not different between pre-ART and post-ART conditions. Despite declines in BAC after ART initiation, no differences in subjective responses were observed with alcohol administration.
  
  
  CONCLUSIONS
  Untreated HIV infection is associated with risk for higher BAC than that observed after ART. These findings indicate that patients with untreated HIV disease who ingest alcohol are at greater risk for alcohol associated adverse events and toxicities and underscores the need for simultaneous treatment of alcohol use disorders and HIV in patients with co-occurring conditions.
authors.affiliation: Department of Psychiatry, Addiction Medicine Research, University of California San Francisco, San Francisco, CA, USA. elinore.mccance-katz@ucsf.edu
authors.forename: Elinore F
authors.initials: EF
authors.lastname: McCance-Katz
authors.forename: Paula J
authors.initials: PJ
authors.lastname: Lum
authors.forename: George
authors.initials: G
authors.lastname: Beatty
authors.forename: Valerie A
authors.initials: VA
authors.lastname: Gruber
authors.forename: Marion
authors.initials: M
authors.lastname: Peters
authors.forename: Petrie M
authors.initials: PM
authors.lastname: Rainey
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000097:blood* / Q000150:complications* / Q000523:psychology; D000480:Alkynes; D019380:Anti-HIV Agents / Q000627:therapeutic use; D048588:Benzoxazines / Q000627:therapeutic use; D003071:Cognition / Q000187:drug effects; D003521:Cyclopropanes; D018450:Disease Progression; D004311:Double-Blind Method; D000431:Ethanol / Q000008:administration & dosage / Q000097:blood* / Q000493:pharmacokinetics; D005260:Female; D015658:HIV Infections / Q000097:blood* / Q000150:complications* / Q000188:drug therapy / Q000523:psychology; D006801:Humans; D007408:Intestinal Absorption; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D019438:Ritonavir / Q000627:therapeutic use
chemical_list: D000480:Alkynes; D019380:Anti-HIV Agents; D048588:Benzoxazines; D003521:Cyclopropanes; D000431:Ethanol; C098320:efavirenz; D019438:Ritonavir