Format

Send to

Choose Destination
Alcohol Clin Exp Res. 2015 Dec;39(12):2422-6. doi: 10.1111/acer.12908. Epub 2015 Oct 28.

Unhealthy Alcohol Use is Associated with Monocyte Activation Prior to Starting Antiretroviral Therapy.

Author information

1
Department of Community Health Systems, San Francisco School of Nursing, University of California, San Francisco, San Francisco, California.
2
Division of HIV/AIDS, San Francisco General Hospital, University of California, San Francisco, San Francisco, California.
3
Department of Internal Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
4
Boston University School of Public Health, Boston, Massachusetts.
5
School of Medicine, Boston University, Boston, Massachusetts.

Abstract

BACKGROUND:

Alcohol use may accelerate HIV disease progression, but the plausible biological mechanisms have not been clearly elucidated.

METHODS:

HIV-positive persons who were not on antiretroviral therapy (ART) completed the baseline assessment for a longitudinal study examining the association of alcohol use with HIV disease markers. Oversampling drinkers, baseline samples were tested for markers of monocyte activation (soluble CD14 [sCD14]), inflammation (interleukin-6 [IL-6]-6), and coagulation (d-dimer). We defined "unhealthy alcohol use" as testing positive using the Alcohol Use Disorders Identification Test-Consumption (≥3 for women and ≥4 for men) in the past 3 months or testing positive using a biomarker of heavy drinking, phosphatidylethanol (≥50 ng/ml). Multiple linear regression was used to examine the associations of unhealthy alcohol use with sCD14, log10 IL-6, and d-dimer.

RESULTS:

Compared to those who were abstinent from alcohol, unhealthy drinkers had significantly higher sCD14 levels (mean = 1,676 vs. 1,387 ng/ml; mean difference [95% confidence interval (CI)] = 289 [83, 495], p < 0.01). In analyses adjusted for demographic factors, current cigarette smoking, and HIV disease markers, unhealthy drinkers continued to display significantly higher sCD14 levels compared to those who were abstinent from alcohol (adjusted mean = 1,670 vs. 1,406 ng/ml; adjusted mean difference [95% CI] = 264 [47, 480], p = 0.02). Unhealthy alcohol use was not significantly associated with IL-6 or d-dimer levels.

CONCLUSIONS:

Unhealthy alcohol use was independently associated with a marker of monocyte activation (i.e., higher sCD14) that predicts mortality in treated HIV infection. Longitudinal research should examine whether unhealthy alcohol use predicts changes in sCD14 prior to and following ART initiation.

KEYWORDS:

Alcohol; HIV/AIDS; Immune Activation; Microbial Translocation

PMID:
26509359
PMCID:
PMC4712082
DOI:
10.1111/acer.12908
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Wiley Icon for PubMed Central
Loading ...
Support Center