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AIDS Behav. 2017 Nov;21(Suppl 2):204-215. doi: 10.1007/s10461-017-1895-2.

Alcohol Types and HIV Disease Progression Among HIV-Infected Drinkers Not Yet on Antiretroviral Therapy in Russia and Uganda.

Author information

1
Department of Medicine, Mbarara Regional Referral Hospital, Mbarara, Uganda. asiimwesteve@gmail.com.
2
Department of Epidemiology and Biostatistics, University of California San Francisco, 550 16th Street, 2nd floor, Mission Hall: Global Health and Clinical Sciences Building, San Francisco, CA, 94158, USA. asiimwesteve@gmail.com.
3
Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
4
Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA.
5
School of Public Health, Data Coordinating Center, Boston University, Boston, MA, USA.
6
Department of Medicine, Mbarara Regional Referral Hospital, Mbarara, Uganda.
7
First St. Petersburg Pavlov State Medical University, St. Petersburg, Russia.
8
St. Petersburg Bekhterev Research Psychoneurological Institute, St. Petersburg, Russia.
9
Department of Medicine, Section of General Internal Medicine, Clinical Addiction Research and Education Unit, Boston University School of Medicine/Boston Medical Center, Boston, MA, USA.
10
Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA.
11
Department of Epidemiology and Biostatistics, University of California San Francisco, 550 16th Street, 2nd floor, Mission Hall: Global Health and Clinical Sciences Building, San Francisco, CA, 94158, USA.

Abstract

In HIV-infected drinkers, alcohol types more likely to cause inflammation could plausibly increase the risk of HIV disease progression. We therefore assessed the association between alcohol type and plasma HIV RNA level (HIV viral load) among HIV-infected drinkers not on antiretroviral therapy (ART) in Russia and Uganda. We analyzed the data of participants from cohorts in Russia and Uganda and assessed their HIV viral load at enrollment by the alcohol type predominantly consumed. We defined predominant alcohol type as the alcohol type contributing >50% of total alcohol consumption in the 1 month (Russia) or 3 months (Uganda) prior to enrollment. Using multiple linear regression, we compared log10 HIV viral load by predominant alcohol type, controlling for age, gender, socioeconomic status, total number of standard drinks, frequency of drinking ≥6 drinks/occasion, and in Russia, history of injection drug use. Most participants (99.2% of 261 in Russia and 98.9% of 352 in Uganda) predominantly drank one alcohol type. In Russia, we did not find evidence for differences in viral load levels between drinkers of fortified wine (n = 5) or hard liquor (n = 49), compared to drinkers of beer/low-ethanol-content cocktails (n = 163); however, wine/high-ethanol-content cocktail drinkers (n = 42) had higher mean log10 viral load than beer/low-ethanol-content cocktail drinkers (β = 0.38, 95% CI 0.07-0.69; p = 0.02). In Uganda, we did not find evidence for differences in viral load levels between drinkers of locally-brewed beer (n = 41), commercially-distilled spirits (n = 38), or locally-distilled spirits (n = 43), compared to drinkers of commercially-made beer (n = 218); however, wine drinkers (n = 8) had lower mean log10 HIV viral load (β = -0.65, 95% CI -1.36 to 0.07, p = 0.08), although this did not reach statistical significance. Among HIV-infected drinkers not yet on ART in Russia and Uganda, we observed an association between the alcohol type predominantly consumed and the HIV viral load level in the Russia sample. These exploratory results suggest that, in addition to total number of drinks and drinking patterns, alcohol type might be a dimension of alcohol use that merits examination in studies of HIV and alcohol related outcomes.

KEYWORDS:

Alcohol types; HIV viral load; HIV-disease progression; HIV-infected patients; Russia; Uganda

PMID:
28856539
PMCID:
PMC5660666
[Available on 2018-11-01]
DOI:
10.1007/s10461-017-1895-2
[Indexed for MEDLINE]

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