Alcohol use and immune reconstitution among HIV-infected patients on antiretroviral therapy in Nairobi, Kenya
Open accessAbstract
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.
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Only two of the 24 eligible studies reported on the integration status of AUD interventions in general health care settings in sub-Saharan Africa.
“2 (8%) studies reported on AUD interventions integrated into general health care settings.”
From Integration of Alcohol Use Disorder Interventions in General Health Care Settings in Sub-Saharan Africa: A Scoping Review (2022) · cites this paper as [57]
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References 26 · Cited by 8
- Authors
- Cagle, A., McGrath, C., Richardson, B. A., Donovan, D., Sakr, S., Yatich, N., Ngomoa, R., Chepngeno Langat, A., John-Stewart, G., & Chung, M. H.
- Affiliations
- University of Washington (US)
- The University of Texas Medical Branch at Galveston (US)
- Coptic Hope Center, Coptic Hospital, Nairobi, Kenya
- Centers for Disease Control and Prevention, Nairobi, Kenya
- Corresponding author
- Cagle, Anthony
- Venue
- AIDS Care
- Publisher
- Informa UK Limited
- Published
- 2017-01-29
- Volume
- 29
- Issue
- 9
- Pages
- 1192-1197
- ISSN
- 0954-0121 (ISSN-L)
- 1360-0451
- PMC
- PMC6009824
- OpenAlex
- W2582290048
- Cited by
- 8
- References
- 26
- Citations by year
- 2022: 3 · 2021: 1 · 2020: 1 · 2019: 2 · 2018: 1
- FWCI
- 0.84
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- AIDS Care (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- eCommons - AKU (Aga Khan University) (submittedVersion)
- Funders
- President’s Emergency Plan for AIDS Relief (PEPFAR) (U62/CCU024512)
- Centers for Disease Control and Prevention
- University of Washington STD/AIDS Research Training Fellowship (NIH NRSA T32AI007140, K12HD052023)
- Building Interdisciplinary Research Careers in Women’s Health Program-BIRCWH
- Topics
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Life Sciences › Immunology and Microbiology › Virology › HIV Research and Treatment
- Health Sciences › Medicine › Emergency Medicine › HIV-related health complications and treatments
- Keywords
- alcohol consumption, HIV infection, immune reconstitution, CD4 count, antiretroviral therapy, hazardous drinking, medication adherence, socioeconomic status, Nairobi
- MeSH terms
- Immune Reconstitution, Adult, Alcohol Drinking, Ambulatory Care Facilities, Female, Follow-Up Studies, Humans, Kenya, Male, Middle Aged, Surveys and Questionnaires, Retrospective Studies, Social Class, Socioeconomic Factors, Urban Population, HIV Infections, Prevalence, Disease Progression, CD4 Lymphocyte Count, Antiretroviral Therapy, Highly Active
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