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

Autor:	Anthony Cagle, Dennis M. Donovan, Grace John-Stewart, Nelly Yatich, Agnes Langat, Sameh Sakr, Christine J. McGrath, Michael H. Chung, Barbra A. Richardson, Richard Ngomoa
Rok vydání:	2017
Předmět:	Adult Male 0301 basic medicine medicine.medical_specialty Health (social science) Every Six Months Alcohol Drinking Urban Population Social Psychology Population HIV Infections Alcohol Social class Ambulatory Care Facilities Article 03 medical and health sciences chemistry.chemical_compound Immune Reconstitution Antiretroviral Therapy Highly Active Surveys and Questionnaires Prevalence Humans Hiv infected patients Medicine education Psychiatry Socioeconomic status Retrospective Studies education.field_of_study business.industry Public Health Environmental and Occupational Health Retrospective cohort study Middle Aged Kenya 030112 virology Antiretroviral therapy CD4 Lymphocyte Count Social Class Socioeconomic Factors chemistry Disease Progression Female business Follow-Up Studies Demography
Zdroj:	AIDS Care. 29:1192-1197
ISSN:	1360-0451 0954-0121
DOI:	10.1080/09540121.2017.1281881
Popis:	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.
Databáze:	OpenAIRE
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