FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W2161878929> ?p ?o ?g. }

• W2161878929 endingPage "e130" @default.
• W2161878929 startingPage "e129" @default.
• W2161878929 abstract "To the Editors: INTRODUCTION The association between alcohol use and indicators of HIV progression through adherence has been documented1-3; however, a direct association between alcohol use and HIV viral load and CD4 count has not been established. Immunologic studies have searched for a biological mechanism by which alcohol may directly affect the immune function of HIV-positive patients. Alcohol significantly enhanced HIV R5 strain infection in monocyte-derived macrophages, treated ex vivo.4 Samet et al5 conducted a 7-year longitudinal study which examined the independent association between HIV progression and alcohol use. Heavy alcohol consumption was not directly associated with higher HIV RNA levels among subjects receiving highly active antiretroviral therapy (HAART).4 We examined the relationship between alcohol use and viral load-independent of adherence to HAART. Focus was placed on the HAART using group, since Samet et al observed that alcohol's effects on the liver could potentially affect the metabolism of antiretroviral medications, which may account for the associations between alcohol and HIV disease progression.6 METHODS Participants Participants for the study were recruited from HIV treatment settings in Philadelphia between 2003 and 2005. We studied subjects with a history of alcohol and substance abuse, and as a comparison group, also enrolled a sample of nonalcohol users. Inclusion criteria required that participants had a confirmed seropositive status and were receiving HIV treatment at the time of interview. The trial was approved by the Committee on Human Subjects of the University of Pennsylvania Institutional Review Board. Alcohol Use Data All behavioral data were assessed through self-report. Participant alcohol use was collected using the Risk Assessment Battery. The Risk Assessment Battery measure asked participants of their frequency of alcohol use in the past month with 4 response options: “everyday, a few times a week, a few times a month, and not at all.” Using this measure, we classified our sample into “daily drinkers”, “regular drinkers”, and “nondrinkers”. “Daily drinkers” used alcohol everyday, “regular drinkers” reported drinking a few times a week, and “nondrinkers” reported drinking a few times a month or not at all. HAART Adherence Self-reported adherence to HAART was measured using a 4-point scale (always, usually, sometimes, never), all participants were asked the way in which they took their prescribed medication for HIV. Participants currently not on HAART were provided the choice not on HAART. Based on this adherence schema, we dichotomized HAART users in our sample into “adherers” (always taking their medication), and “nonadherers” (usually, sometimes, or never taking their medicine). Laboratory Data Our primary outcomes were HIV viral load and absolute CD4 count. Levels of HIV RNA in plasma were quantified by means of reverse transcriptase-polymerase chain reaction assay (Roche Molecular Systems, Branchburg, NJ) according to the manufacturer protocol. The minimal detectable level of HIV RNA was 50 copies per milliliter. Data Analysis To investigate the adjusted association between viral load and alcohol use, we first used logistic regression to examine the relationship between detectable viral load and daily alcohol use, adjusted for adherence (for HAART users only) and age, race, and gender. Linear regression was employed to study the association between CD4 count and daily alcohol use. Finally, we included “regular drinkers” in the alcohol users group, in addition to the “daily drinkers”, and reran the above analyses. All statistical analyses were carried out in R 2.9.1 (Free Software Foundation, Inc, Boston, MA). RESULTS Sample Description Of our 325 subjects, 241 (74%) were currently on HAART and 84 (26%) were non-HAART users. Table 1 outlines the outcome measures in our study. In our sample, 43.4% of HAART users had a detectable viral load, as compared to 90.5% of the non-HAART users (P < 0.01). There were no significant differences in absolute CD4 count between the groups, and nearly 55% of HAART users were always adherent to HAART. With respect to the alcohol measures, 10.6% of the HAART users and 24.1% of the non-HAART subjects consumed alcohol daily in the past month; 44.2% in the HAART group and 36.1% in the non-HAART group did not drink at all in the past month (P = 0.24).TABLE 1: Summary of Outcome MeasuresAlcohol Use and Viral Load The relationship between detectable viral load and alcohol use was examined. Adjusting for adherence and demographic covariates, daily drinkers had nearly a 4-fold increase in the odds of detectable viral load [odds ratio (OR) = 3.81, P = 0.01, 95% confidence interval (CI) = 1.42 to 11.48], as compared to the remainder of the HAART users in the sample. When we included regular drinkers in our alcohol user group, the adjusted association was no longer significant (OR = 1.29, P = 0.41, 95% CI = 0.70 to 2.33). For non-HAART users, daily drinking was not associated with significantly higher odds of detectable viral load (OR = 2.08, P = 0.62, 95% CI = 0.32 to 41.20). Alcohol Use and CD4 For HAART users, daily alcohol use, adjusted for adherence and demographic factors, was associated with a −41.59 cells per milliliter decrease in CD4 (P = 0.52, 95% CI = −169.24 to 86.06). Among the non-HAART users, daily alcohol use was associated with a 65.6 cells per milliliter decrease in CD4 (P = 0.31, 95% CI = −193.01 to 61.77). DISCUSSION We investigated the direct relationship between alcohol use and HIV viral load. After controlling for adherence and demographic covariates, there remains a strong relationship between daily alcohol use and detectable viral load among participants on HAART. Daily drinkers in our sample had increased odds of detectable viral load, regular drinkers, defined as consuming a few drinks a week, did not. LIMITATIONS This was a cross-sectional study; a longitudinal design may have been more appropriate to investigate the possible association between alcohol use and progression of the HIV virus over time. Given our limited sample size (n = 84) and highly skewed distribution (90.5% detectable viral load) of non-HAART participants, it was difficult to conclude whether the nonsignificant association for this group was due to the inherent lack of statistical power or an underlying biological explanation. IMPLICATIONS AND SUGGESTIONS FOR FUTURE RESEARCH Despite these limitations, our results suggest that there is an association among HAART users between daily alcohol use and viral load. By classifying alcohol users into “daily” and “regular”, we also found that although daily consumption was significantly associated with detectable viral load, regular alcohol use was not. This finding is consistent with previous work that moderate alcohol use is associated with different impact on HIV progression and survival than heavy alcohol use.5,7 In contrast, Samet et al5 established a significant association between heavy alcohol use and CD4 count among non-HAART users, but not among HAART users. Heavy alcohol use in their study was not associated with higher HIV RNA levels for either medication group.5 Our study established an independent relationship for HAART users between heavy alcohol use and HIV RNA levels but inconclusive results among participants not on HAART. In summary, reducing alcohol use, even from daily to a few times a week, may decrease the odds of detectable viral load in patients undergoing HAART therapy. Our results provide evidence in support of Samet hypothesis6 that the association between alcohol use and HIV RNA levels is modified by HAART, and the possibility of drug-drug interaction between HAART and alcohol, whereby alcohol impacts the metabolism of HAART as previously suggested. Evan S. Wu* David S. Metzger† Kevin G. Lynch*‡ Steven D. Douglas§ *Division of Biostatistics, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania †Department of Psychiatry, University of Pennsylvania ‡Department of Psychiatry, University of Pennsylvania §Division of Allergy-Immunology, Children's Hospital of Philadelphia and CHOP Research Institute" @default.
• W2161878929 created "2016-06-24" @default.
• W2161878929 creator A5001597949 @default.
• W2161878929 creator A5025960711 @default.
• W2161878929 creator A5041987414 @default.
• W2161878929 creator A5080507442 @default.
• W2161878929 date "2011-04-15" @default.
• W2161878929 modified "2023-10-07" @default.
• W2161878929 title "Association Between Alcohol Use and HIV Viral Load" @default.
• W2161878929 cites W2034990918 @default.
• W2161878929 cites W2040512636 @default.
• W2161878929 cites W2048698611 @default.
• W2161878929 cites W2076884514 @default.
• W2161878929 cites W2085024145 @default.
• W2161878929 cites W2089374096 @default.
• W2161878929 cites W4249518641 @default.
• W2161878929 doi "https://doi.org/10.1097/qai.0b013e31820dc1c8" @default.
• W2161878929 hasPubMedCentralId "https://www.ncbi.nlm.nih.gov/pmc/articles/3082398" @default.
• W2161878929 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/21532918" @default.
• W2161878929 hasPublicationYear "2011" @default.
• W2161878929 type Work @default.
• W2161878929 sameAs 2161878929 @default.
• W2161878929 citedByCount "50" @default.
• W2161878929 countsByYear W21618789292013 @default.
• W2161878929 countsByYear W21618789292014 @default.
• W2161878929 countsByYear W21618789292015 @default.
• W2161878929 countsByYear W21618789292016 @default.
• W2161878929 countsByYear W21618789292017 @default.
• W2161878929 countsByYear W21618789292018 @default.
• W2161878929 countsByYear W21618789292019 @default.
• W2161878929 countsByYear W21618789292020 @default.
• W2161878929 countsByYear W21618789292021 @default.
• W2161878929 countsByYear W21618789292023 @default.
• W2161878929 crossrefType "journal-article" @default.
• W2161878929 hasAuthorship W2161878929A5001597949 @default.
• W2161878929 hasAuthorship W2161878929A5025960711 @default.
• W2161878929 hasAuthorship W2161878929A5041987414 @default.
• W2161878929 hasAuthorship W2161878929A5080507442 @default.
• W2161878929 hasBestOaLocation W21618789292 @default.
• W2161878929 hasConcept C142462285 @default.
• W2161878929 hasConcept C142853389 @default.
• W2161878929 hasConcept C15744967 @default.
• W2161878929 hasConcept C159047783 @default.
• W2161878929 hasConcept C2781066024 @default.
• W2161878929 hasConcept C3013748606 @default.
• W2161878929 hasConcept C542102704 @default.
• W2161878929 hasConcept C55493867 @default.
• W2161878929 hasConcept C71924100 @default.
• W2161878929 hasConcept C86803240 @default.
• W2161878929 hasConceptScore W2161878929C142462285 @default.
• W2161878929 hasConceptScore W2161878929C142853389 @default.
• W2161878929 hasConceptScore W2161878929C15744967 @default.
• W2161878929 hasConceptScore W2161878929C159047783 @default.
• W2161878929 hasConceptScore W2161878929C2781066024 @default.
• W2161878929 hasConceptScore W2161878929C3013748606 @default.
• W2161878929 hasConceptScore W2161878929C542102704 @default.
• W2161878929 hasConceptScore W2161878929C55493867 @default.
• W2161878929 hasConceptScore W2161878929C71924100 @default.
• W2161878929 hasConceptScore W2161878929C86803240 @default.
• W2161878929 hasIssue "5" @default.
• W2161878929 hasLocation W21618789291 @default.
• W2161878929 hasLocation W21618789292 @default.
• W2161878929 hasLocation W21618789293 @default.
• W2161878929 hasLocation W21618789294 @default.
• W2161878929 hasOpenAccess W2161878929 @default.
• W2161878929 hasPrimaryLocation W21618789291 @default.
• W2161878929 hasRelatedWork W1945359667 @default.
• W2161878929 hasRelatedWork W1973460911 @default.
• W2161878929 hasRelatedWork W1988777930 @default.
• W2161878929 hasRelatedWork W2010046108 @default.
• W2161878929 hasRelatedWork W2024165239 @default.
• W2161878929 hasRelatedWork W2077563405 @default.
• W2161878929 hasRelatedWork W2140412799 @default.
• W2161878929 hasRelatedWork W2332209453 @default.
• W2161878929 hasRelatedWork W2442654169 @default.
• W2161878929 hasRelatedWork W3113841028 @default.
• W2161878929 hasVolume "56" @default.
• W2161878929 isParatext "false" @default.
• W2161878929 isRetracted "false" @default.
• W2161878929 magId "2161878929" @default.
• W2161878929 workType "article" @default.