title: Association of alcohol consumption and HIV surrogate markers in participants of the swiss HIV cohort study.
abstract: BACKGROUND
  Alcohol consumption may affect the course of HIV infection and/or antiretroviral therapy (ART). The authors investigated the association between self-reported alcohol consumption and HIV surrogate markers in both treated and untreated individuals.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Over a 7-year period, the authors analyzed 2 groups of individuals in the Swiss HIV Cohort Study: (1) ART-naïve individuals remaining off ART and (2) individuals initiating first ART. For individuals initiating first ART, time-dependent Cox proportional hazards models were used to assess the association between alcohol consumption, virological failure, and ART interruption. For both groups, trajectories of log-transformed CD4 cell counts were analyzed using linear mixed models with repeated measures.
  
  
  RESULTS
  The authors included 2982 individuals initiating first ART and 2085 ART naives. In individuals initiating first ART, 241 (8%) experienced virological failure. Alcohol consumption was not associated with virological failure. ART interruption was noted in 449 (15%) individuals and was more prevalent in severe compared with none/light health risk drinkers [hazard ratio: 2.24, 95% confidence interval: 1.42 to 3.52]. The association remained significant even after adjusting for nonadherence. The authors did not find an association between alcohol consumption and change in CD4 cell count over time in either group.
  
  
  CONCLUSIONS
  No effect of alcohol consumption on either virological failure or CD4 cell count in both groups of ART-initiating and ART-naive individuals was found. However, severe drinkers were more likely to interrupt ART. Efforts on ART continuation should be especially implemented in individuals reporting high alcohol consumption.
authors.affiliation: *Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital Aarau, Aarau, Switzerland; †Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, Basel, Switzerland; ‡Clinic for Infectious Diseases, University Hospital Berne, University of Berne, Berne, Switzerland; §Division of Infectious Diseases and Hospital Epidemiology, University Hospital Lausanne, University of Lausanne, Lausanne, Switzerland; ‖Division of Infectious Diseases and Hospital Epidemiology, University Hospital Geneva, University of Geneva, Geneva, Switzerland; ¶Division of Infectious Diseases, Regional Hospital Lugano, Lugano, Switzerland; #Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland; **Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zürich, University of Zürich, Zürich, Switzerland; and ††Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, Basel, Switzerland.
authors.forename: Anna
authors.initials: A
authors.lastname: Conen
authors.forename: Qing
authors.initials: Q
authors.lastname: Wang
authors.forename: Tracy R
authors.initials: TR
authors.lastname: Glass
authors.forename: Christoph A
authors.initials: CA
authors.lastname: Fux
authors.forename: Maria C
authors.initials: MC
authors.lastname: Thurnheer
authors.forename: Christina
authors.initials: C
authors.lastname: Orasch
authors.forename: Alexandra
authors.initials: A
authors.lastname: Calmy
authors.forename: Enos
authors.initials: E
authors.lastname: Bernasconi
authors.forename: Pietro
authors.initials: P
authors.lastname: Vernazza
authors.forename: Rainer
authors.initials: R
authors.lastname: Weber
authors.forename: Heiner C
authors.initials: HC
authors.lastname: Bucher
authors.forename: Manuel
authors.initials: M
authors.lastname: Battegay
authors.forename: Jan
authors.initials: J
authors.lastname: Fehr
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects*; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D015415:Biomarkers; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D013557:Switzerland / Q000453:epidemiology; D019562:Viral Load; D016903:Drug Monitoring
chemical_list: D044966:Anti-Retroviral Agents; D015415:Biomarkers