Impact of alcohol use disorder severity on human immunodeficiency virus (HIV) viral suppression and CD4 count in three international cohorts of people with HIV.
CD4
HIV
alcohol use disorder
viral suppression
Journal
Alcohol, clinical & experimental research
ISSN: 2993-7175
Titre abrégé: Alcohol Clin Exp Res (Hoboken)
Pays: United States
ID NLM: 9918609780906676
Informations de publication
Date de publication:
Apr 2023
Apr 2023
Historique:
revised:
02
01
2023
received:
31
08
2022
accepted:
30
01
2023
pmc-release:
01
04
2024
medline:
1
5
2023
pubmed:
18
2
2023
entrez:
17
2
2023
Statut:
ppublish
Résumé
Alcohol use has been linked to worse human immunodeficiency virus (HIV) immunologic/virologic outcomes, yet few studies have explored the effects of alcohol use disorder (AUD). This study assessed whether AUD severity is associated with HIV viral suppression and CD4 count in the three cohorts of the Uganda Russia Boston Alcohol Network for Alcohol Research Collaboration on HIV/AIDS (URBAN ARCH) Consortium. People with HIV (PWH) in Uganda (n = 301), Russia (n = 400), and Boston (n = 251), selected in-part based on their alcohol use, were included in analyses. Logistic and linear regressions were used to assess the cross-sectional associations between AUD severity (number of DSM-5 diagnostic criteria) and (1) HIV viral suppression, and (2) CD4 count (cells/mm The proportion of females was 51% (Uganda), 34% (Russia), and 33% (Boston); mean age (SD) was 40.7 (9.6), 38.6 (6.3), and 52.1 (10.5), respectively. All participants in Uganda and all but 27% in Russia and 5% in Boston were on antiretroviral therapy. In Uganda, 32% met criteria for AUD, 92% in Russia, and 43% in Boston. The mean (SD) number of AUD criteria was 1.6 (2.4) in Uganda, 5.6 (3.3) in Russia, and 2.4 (3.1) in Boston. Most participants had HIV viral suppression (Uganda 92%, Russia 57%, Boston 87%); median (IQR) CD4 count was 673 (506, 866), 351 (201, 542), and 591 (387, 881), respectively. In adjusted models, there were no associations between AUD severity and HIV viral suppression: adjusted odds ratios (AOR) (95%CI) per 1 additional AUD criterion in Uganda was 1.08 (0.87, 1.33); Russia 0.98 (0.92, 1.04); and Boston 0.95 (0.84, 1.08) or CD4 count: mean difference (95%CI) per 1 additional criterion: 5.78 (-7.47, 19.03), -3.23 (-10.91, 4.44), and -8.18 (-24.72, 8.35), respectively. In three cohorts of PWH, AUD severity was not associated with HIV viral suppression or CD4 count. PWH with AUD in the current era of antiretroviral therapy can achieve virologic control.
Sections du résumé
BACKGROUND
Alcohol use has been linked to worse human immunodeficiency virus (HIV) immunologic/virologic outcomes, yet few studies have explored the effects of alcohol use disorder (AUD). This study assessed whether AUD severity is associated with HIV viral suppression and CD4 count in the three cohorts of the Uganda Russia Boston Alcohol Network for Alcohol Research Collaboration on HIV/AIDS (URBAN ARCH) Consortium.
METHODS
People with HIV (PWH) in Uganda (n = 301), Russia (n = 400), and Boston (n = 251), selected in-part based on their alcohol use, were included in analyses. Logistic and linear regressions were used to assess the cross-sectional associations between AUD severity (number of DSM-5 diagnostic criteria) and (1) HIV viral suppression, and (2) CD4 count (cells/mm
RESULTS
The proportion of females was 51% (Uganda), 34% (Russia), and 33% (Boston); mean age (SD) was 40.7 (9.6), 38.6 (6.3), and 52.1 (10.5), respectively. All participants in Uganda and all but 27% in Russia and 5% in Boston were on antiretroviral therapy. In Uganda, 32% met criteria for AUD, 92% in Russia, and 43% in Boston. The mean (SD) number of AUD criteria was 1.6 (2.4) in Uganda, 5.6 (3.3) in Russia, and 2.4 (3.1) in Boston. Most participants had HIV viral suppression (Uganda 92%, Russia 57%, Boston 87%); median (IQR) CD4 count was 673 (506, 866), 351 (201, 542), and 591 (387, 881), respectively. In adjusted models, there were no associations between AUD severity and HIV viral suppression: adjusted odds ratios (AOR) (95%CI) per 1 additional AUD criterion in Uganda was 1.08 (0.87, 1.33); Russia 0.98 (0.92, 1.04); and Boston 0.95 (0.84, 1.08) or CD4 count: mean difference (95%CI) per 1 additional criterion: 5.78 (-7.47, 19.03), -3.23 (-10.91, 4.44), and -8.18 (-24.72, 8.35), respectively.
CONCLUSIONS
In three cohorts of PWH, AUD severity was not associated with HIV viral suppression or CD4 count. PWH with AUD in the current era of antiretroviral therapy can achieve virologic control.
Identifiants
pubmed: 36799302
doi: 10.1111/acer.15031
pmc: PMC10198460
mid: NIHMS1884158
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
704-712Subventions
Organisme : NIAAA NIH HHS
ID : U24 AA020779
Pays : United States
Organisme : NIAAA NIH HHS
ID : U01 AA020780
Pays : United States
Organisme : NIAAA NIH HHS
ID : U24 AA020778
Pays : United States
Organisme : NIAID NIH HHS
ID : P30 AI042853
Pays : United States
Organisme : NIAAA NIH HHS
ID : U01 AA020784
Pays : United States
Organisme : NIAAA NIH HHS
ID : U01 AA020776
Pays : United States
Informations de copyright
© 2023 The Authors. Alcohol: Clinical and Experimental Research published by Wiley Periodicals LLC on behalf of Research Society on Alcohol.
Références
Alcohol Clin Exp Res. 2005 Jul;29(7):1190-7
pubmed: 16046874
Arch Intern Med. 1998 Apr 13;158(7):734-40
pubmed: 9554679
AIDS Care. 2005 Aug;17(6):773-83
pubmed: 16036264
Drug Alcohol Depend. 2018 Aug 1;189:21-29
pubmed: 29859388
J Acquir Immune Defic Syndr. 2017 Dec 15;76(5):493-500
pubmed: 28930769
BMC Infect Dis. 2017 Apr 11;17(1):263
pubmed: 28399823
AIDS Care. 2009 Feb;21(2):168-77
pubmed: 19229685
Health Psychol. 2008 Sep;27(5):628-37
pubmed: 18823189
Popul Health Metr. 2017 Feb 10;15(1):4
pubmed: 28183309
J Acquir Immune Defic Syndr. 2006 Dec 1;43(4):411-7
pubmed: 17099312
AIDS. 2001 Jan 5;15(1):77-85
pubmed: 11192871
AIDS Patient Care STDS. 2015 Jul;29(7):384-8
pubmed: 26114665
Contemp Clin Trials Commun. 2020 Jul 16;19:100625
pubmed: 33659761
J Clin Psychiatry. 1998;59 Suppl 20:22-33;quiz 34-57
pubmed: 9881538
AIDS Care. 2018 Feb;30(2):150-159
pubmed: 29034725
Alcohol Clin Exp Res. 2016 Mar;40(3):529-35
pubmed: 26916712
Drug Alcohol Depend. 1995 Jul;39(1):37-44
pubmed: 7587973
Alcohol Clin Exp Res. 2016 Oct;40(10):2056-2072
pubmed: 27696523
Curr HIV/AIDS Rep. 2010 Nov;7(4):226-33
pubmed: 20814765
AIDS. 2002 Mar 29;16(5):767-74
pubmed: 11964533
Subst Abus. 2017 Jul-Sep;38(3):269-277
pubmed: 27925867
AIDS Behav. 2019 Jan;23(1):140-151
pubmed: 29995206
AIDS Behav. 2016 Jan;20 Suppl 1:S1-18
pubmed: 26362168
J Acquir Immune Defic Syndr. 2018 Apr 15;77(5):492-501
pubmed: 29303844
AIDS Care. 2017 Sep;29(9):1129-1136
pubmed: 28513200
Drug Alcohol Depend. 2010 Dec 1;112(3):178-93
pubmed: 20705402
J Acquir Immune Defic Syndr. 2016 Dec 1;73(4):419-425
pubmed: 27243904
J Health Care Poor Underserved. 2003 May;14(2):244-55
pubmed: 12739303
J Acquir Immune Defic Syndr. 2019 Nov 1;82(3):245-251
pubmed: 31343455
AIDS. 2020 Dec 1;34(15):2285-2294
pubmed: 33048870
J Stud Alcohol. 1995 Nov;56(6):642-53
pubmed: 8558896
Subst Abuse Treat Prev Policy. 2019 Nov 14;14(1):52
pubmed: 31727086
J Acquir Immune Defic Syndr. 2009 Oct 1;52(2):180-202
pubmed: 19668086
AIDS Behav. 2018 Mar;22(3):791-799
pubmed: 27990579
Am J Med. 2003 May;114(7):573-80
pubmed: 12753881