September 24, 2012

CD4 Counts Not Affected by Alcohol Consumption

Consuming alcohol doesn’t appear to have a deleterious effect on CD4 cell counts among people living with HIV receiving antiretroviral (ARV) therapy, according to a new Johns Hopkins University study published ahead of print by the Journal of Acquired Immune Deficiency Syndromes (JAIDS). “Among individuals initiating ARV therapy,” Geetanjali Chander, MD, MPH, and his colleagues write,  “the benefits of therapy and viral suppression on the immune system outweigh detrimental effects of alcohol, reinforcing the importance of initiating [HIV treatment] and ensuring adequate adherence to therapy.”

According to the analysis of available CD4 cell count data, along with alcohol use surveys completed by more than 1,100 people living with HIV starting ARV treatment, Chander’s team found that neither the total number of drinks consumed nor the frequency of alcohol use on a weekly basis had an effect on CD4 cell counts. This held true in analyses comparing women and men, as well as those who managed to achieve and maintain undetectable viral loads compared with those who did not.

While Chander’s group concludes that people living with HIV who consume alcohol and maintain undetectable viral loads “can reap the same immunologic benefits of those who do not drink alcohol,” the authors also note some of the potential dangers of excessive drinking. They caution: “With alcohol’s negative effect on HIV medication adherence and viral suppression and its association with increased transmission behaviors”—not to mention liver toxicity, particularly among those coinfected with hepatitis C or hepatitis B—”screening for alcohol use and brief interventions encouraging reduction or abstinence in alcohol use is essential to optimize the management of HIV.”

To read the JAIDS report (paid subscription required), click here.

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Previous Comments:

Chuck Etheridge, Dunwoody, 2012-09-27 15:06:09
23 years ago my partner dies with a viral load of over 90,000 and an undetectable CD4 count. My infection progressed slowly, though several years ago I was taking the classic handful of drung each day. Then, as soon as the VA here (Atlanta) got it I was among the first to be prescribed it. I quit taking all other meds, other than a few anti-depressants, and ahve been taking 1 Atripla per day since. My VL is now less than 20 and my CD4 count is in the 400s. Is that progress or what?

Bradley Miller, Gainesville, 2012-09-26 16:28:32
The consumption of alcohol in moderation may not affect CD4 counts,but the the abuse of alcohol most certainly will. This should be included in this story. Alcoholism is a serious disease. Alcohol affects every organ in the body. The risk is not limited to the liver alone. Abuse causes the immune system to be constantly taxed. Because of the emotional and psychological strain of dealing with HIV/AIDS a disproportionate number turn to alcohol and drugs to sooth the pain. Please add a caveat.