Two longitudinal studies from Brown University have found that persons living with HIV (PLWH) who have alcohol use disorder or engage in high levels of alcohol consumption may be at increased risk of all-cause mortality. This is increasingly significant in terms of clinical research as resent estimates indicate that approximately 61% of PLWH have consumed alcohol in the past year with nearly 15% reporting to be heavy drinkers.
Dr. Christopher W. Kahler, professor and chair in the department of behavioral and social sciences in the Brown University School of Public Health and SHARC executive committee member, and his colleagues looked at the impact of past 30-day frequency drinking on both HIV- and non-HIV-related clinical outcomes. They also examined the extent to which the reduction of adherence to antiretroviral therapy (ART) could be seen as the cause for these outcomes. The team used data from the Study to Understand the Natural Hisotry of HIV/AIDS in the Era of Effective Therapy. They used longitudinal mediation analysis, which allowed them to estimate natural direct effects of heavy drinking frequency on clinical outcomes and natural indirect effects mediated through ART adherence.
Essentially, Dr. Kahler and his colleagues found that PLWH who also engaged in heavy drinking experienced deleterious effects on multiple clinical biomarkers, including HIV VL, CG4+ T-cell counts, and estimated liver fibrosis, while reducing such engagement exhibited benefits, such as increasing ART adherence and reduction of the negative effects of heavy drinking on the body.
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