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Alcohol use and immune reconstitution among HIV-infected patients on antiretroviral therapy in Nairobi, Kenya.

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Title: Alcohol use and immune reconstitution among HIV-infected patients on antiretroviral therapy in Nairobi, Kenya.
Authors: Cagle, Anthony (AUTHOR), McGrath, Christine (AUTHOR), Richardson, Barbra A. (AUTHOR), Donovan, Dennis (AUTHOR), Sakr, Sameh (AUTHOR), Yatich, Nelly (AUTHOR), Ngomoa, Richard (AUTHOR), Chepngeno Langat, Agnes (AUTHOR), John-Stewart, Grace (AUTHOR), Chung, Michael H. (AUTHOR)
Source: AIDS Care. Sep2017, Vol. 29 Issue 9, p1192-1197. 6p.
Subjects: Alcohol drinking, Psychology of HIV-positive persons, Longitudinal method, Questionnaires, Regression analysis, Antiretroviral agents, CD4 lymphocyte count
Geographic Terms: Sub-Saharan Africa
Abstract: Studies on the effects of alcohol use on HIV disease progression have been contradictory, with at least one study finding a positive effect of low alcohol consumption on CD4 count. In addition, most such studies have taken place in the developed West. We investigated the association between alcohol use and immune reconstitution through CD4 count response among HIV-infected individuals on antiretroviral therapy (ART) at an urban sub-Saharan African clinic. This was a retrospective cohort study of treatment-naïve HIV-infected adults initiating ART in Nairobi, Kenya and followed for 12 months between January 2009 and December 2012. At enrollment, a standardized questionnaire was used to collect data on sociodemographic variables and alcohol consumption. CD4 count was measured every six months. Linear regression models assessed the association between CD4 count and alcohol consumption, categorized as abstinent, moderate, or hazardous. Overall, 854 participants were included, 522 of which were women, with 85 (25.6%) men and 50 (9.6%) women reporting any alcohol use, and 8 (2.4%) men and 7 (1.3%) women reporting hazardous drinking. At baseline, alcohol use was associated with higher education and socioeconomic status. Median CD4 count was higher among alcohol users compared to those who abstained at baseline and at 6 and 12 months post-ART initiation, although this was only significant at 6 months. There were no differences in adherence between abstainers and drinkers. While overall alcohol use was significantly associated with higher CD4 counts, moderate and hazardous use treated separately were not. We conclude that, while alcohol use was associated with higher CD4 counts at 12 months post-ART, the mechanism for this association is unclear but may reflect unmeasured socioeconomic or nutritional differences. Additional research is required on the specific drinking patterns of this population and the types of alcoholic beverages consumed to clarify this relationship. [ABSTRACT FROM AUTHOR]
Copyright of AIDS Care is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Alcohol use and immune reconstitution among HIV-infected patients on antiretroviral therapy in Nairobi, Kenya.
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  Data: <searchLink fieldCode="JN" term="%22AIDS+Care%22">AIDS Care</searchLink>. Sep2017, Vol. 29 Issue 9, p1192-1197. 6p.
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  Data: <searchLink fieldCode="DE" term="%22Alcohol+drinking%22">Alcohol drinking</searchLink><br /><searchLink fieldCode="DE" term="%22Psychology+of+HIV-positive+persons%22">Psychology of HIV-positive persons</searchLink><br /><searchLink fieldCode="DE" term="%22Longitudinal+method%22">Longitudinal method</searchLink><br /><searchLink fieldCode="DE" term="%22Questionnaires%22">Questionnaires</searchLink><br /><searchLink fieldCode="DE" term="%22Regression+analysis%22">Regression analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Antiretroviral+agents%22">Antiretroviral agents</searchLink><br /><searchLink fieldCode="DE" term="%22CD4+lymphocyte+count%22">CD4 lymphocyte count</searchLink>
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  Data: <searchLink fieldCode="DE" term="%22Sub-Saharan+Africa%22">Sub-Saharan Africa</searchLink>
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  Data: Studies on the effects of alcohol use on HIV disease progression have been contradictory, with at least one study finding a positive effect of low alcohol consumption on CD4 count. In addition, most such studies have taken place in the developed West. We investigated the association between alcohol use and immune reconstitution through CD4 count response among HIV-infected individuals on antiretroviral therapy (ART) at an urban sub-Saharan African clinic. This was a retrospective cohort study of treatment-naïve HIV-infected adults initiating ART in Nairobi, Kenya and followed for 12 months between January 2009 and December 2012. At enrollment, a standardized questionnaire was used to collect data on sociodemographic variables and alcohol consumption. CD4 count was measured every six months. Linear regression models assessed the association between CD4 count and alcohol consumption, categorized as abstinent, moderate, or hazardous. Overall, 854 participants were included, 522 of which were women, with 85 (25.6%) men and 50 (9.6%) women reporting any alcohol use, and 8 (2.4%) men and 7 (1.3%) women reporting hazardous drinking. At baseline, alcohol use was associated with higher education and socioeconomic status. Median CD4 count was higher among alcohol users compared to those who abstained at baseline and at 6 and 12 months post-ART initiation, although this was only significant at 6 months. There were no differences in adherence between abstainers and drinkers. While overall alcohol use was significantly associated with higher CD4 counts, moderate and hazardous use treated separately were not. We conclude that, while alcohol use was associated with higher CD4 counts at 12 months post-ART, the mechanism for this association is unclear but may reflect unmeasured socioeconomic or nutritional differences. Additional research is required on the specific drinking patterns of this population and the types of alcoholic beverages consumed to clarify this relationship. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
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  Data: <i>Copyright of AIDS Care is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=124091005
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        Value: 10.1080/09540121.2017.1281881
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      – Code: eng
        Text: English
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        PageCount: 6
        StartPage: 1192
    Subjects:
      – SubjectFull: Alcohol drinking
        Type: general
      – SubjectFull: Psychology of HIV-positive persons
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      – SubjectFull: Longitudinal method
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      – SubjectFull: Antiretroviral agents
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      – SubjectFull: CD4 lymphocyte count
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      – SubjectFull: Sub-Saharan Africa
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      – TitleFull: Alcohol use and immune reconstitution among HIV-infected patients on antiretroviral therapy in Nairobi, Kenya.
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