Association of Alcohol Consumption With CD4 Recovery After Antiretroviral Therapy Initiation in St. Petersburg, Russia.

Autor:	McLaughlin A; Section of Infectious Diseases, Department of Medicine, Boston Medical Center, Boston, MA., Lin N; Section of Infectious Diseases, Department of Medicine, Boston Medical Center, Boston, MA., Jiang W; Department of Biostatistics, Boston University School of Public Health, Boston, MA., Lodi S; Department of Biostatistics, Boston University School of Public Health, Boston, MA., Lioznov D; Department of Infectious Diseases and Epidemiology, First Pavlov State Medical University, St. Petersburg, Russia., Patts G; Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, MA., Gnatienko N; Department of Medicine, Boston Medical Center, Boston, MA., Blokhina E; First Pavlov State Medical University, St. Petersburg, Russia., Bendiks S; Department of Medicine, Boston Medical Center, Boston, MA., Freiberg MS; Department of Medicine, Vanderbilt University School of Medicine, Nashville Veterans Affairs Medical Center, Tennessee Valley Healthcare System, Nashville, TN., Tindle HA; Department of Medicine, Vanderbilt University School of Medicine, Nashville Veterans Affairs Medical Center, Tennessee Valley Healthcare System, Nashville, TN., Krupitsky E; First Pavlov State Medical University, St. Petersburg, Russia.; V.M. Bekhterev National Research Medical Center for Psychiatry and Neurology, St. Petersburg, Russia., Hahn JA; Department of Medicine, University of California, San Francisco, San Francisco, CA; and., Samet JH; Department of Medicine, Boston Medical Center, Boston, MA., So-Armah K; Department of Medicine, Boston University School of Medicine, Boston, MA.
Jazyk:	angličtina
Zdroj:	Journal of acquired immune deficiency syndromes (1999) [J Acquir Immune Defic Syndr] 2023 Nov 01; Vol. 94 (3), pp. 244-252.
DOI:	10.1097/QAI.0000000000003250
Abstrakt:	Background: Delayed CD4 recovery after initiating antiretroviral therapy (ART) is a novel potential mechanism by which alcohol consumption leads to increased morbidity and mortality in people with HIV. We hypothesized that alcohol consumption at ART initiation is associated with slower CD4 recovery. Methods: We retrospectively analyzed 2 pooled longitudinal alcohol/HIV cohorts (2014-2019) in St. Petersburg, Russia. Eligible participants initiated the first ART during parent studies; had alcohol consumption assessed by the blood biomarker, phosphatidylethanol (PEth), at the last research visit before ART initiation; and had ≥1 CD4 count measurement before and after initiating ART. Participants were stratified by low, moderate, and high PEth (<8, 8-80, and >80 ng/mL, respectively). We used random-effects piecewise linear regression models to estimate CD4 recovery, defined as CD4 count change per 30 days after ART initiation, by the alcohol group. Results: Of 60 eligible participants, median age was 34 years and 28% were female. The median pre-ART PEth in the low, moderate, and high PEth groups were <8, 23, and 232 ng/mL, respectively. After starting ART, the CD4 count increased by 13.60 cells/mm3/mo (95% CI: 0.33 to 26.87) with low PEth, 0.93 cells/mm3/mo (95% CI: -6.18 to 8.04) with moderate PEth, and 2.33 cells/mm3/mo (95% CI: -3.44 to 8.09) with high PEth. Conclusions: Among Russians with HIV, we observed faster CD4 recovery after ART initiation in those with low alcohol consumption compared with those with moderate and high alcohol consumption, as assessed by PEth. This analysis provides further evidence for the possible value of alcohol reduction interventions for people with HIV who are initiating ART. Competing Interests: The authors have no conflicts of interest to disclose. (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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