BACKGROUND:: Alcohol consumption may affect the course of HIV infection and/or antiretroviral therapy (ART). We investigated the association between self-reported alcohol consumption and HIV surrogate markers in both treated and untreated individuals.
DESIGN:: Prospective cohort study METHODS:: Over a 7-year period we analyzed two groups of individuals in the Swiss HIV Cohort Study: 1) ART naïve individuals remaining off ART and 2) individuals initiating first ART. For individuals initiating first ART, time-dependent Cox proportional hazards models were used to assess the association between alcohol consumption, virological failure and ART interruption. For both groups, trajectories of log transformed CD4 cell counts were analyzed using linear mixed models with repeated measures.
RESULTS:: We included 2982 individuals initiating first ART and 2085 ART naïves. In individuals initiating first ART, 241 (8%) experienced virological failure. Alcohol consumption was not associated with virological failure. ART interruption was noted in 449 (15%) individuals and was more prevalent in severe compared to none/light health risk drinkers (hazard ratio (HR) 2.24, 95% confidence interval (CI) 1.42 to 3.52). The association remained significant even after adjusting for non-adherence. We did not find an association between alcohol consumption and change in CD4 cell count over time in either group.
CONCLUSIONS:: No effect of alcohol consumption on either virological failure or CD4 cell count in both groups of ART initiating and naïve individuals was found. However, severe drinkers were more likely to interrupt ART. Efforts on ART continuation should be especially implemented in individuals reporting high alcohol consumption.