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ISSN 2155-6113

Journal of AIDS & Clinical Research
Open Access

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Review Article

Alcohol and Antiretroviral Therapy - A Lethal Cocktail

Michelle Schneider1*, Manuela Neuman2,3, Matthew Chersich4,5 and Charles Parry1,6

1Alcohol & Drug Abuse Research Unit, Cape Town, South African Medical Research Council, South Africa

2In Vitro Drug Safety and Biotechnology, MaRS, Toronto, ON, Canada

3Departments of Pharmacology & Toxicology and International Health, Faculty of Medicine, University of Toronto, Canada

4Centre for Health Policy, School of Public Health University of Witwatersrand, Johannesburg, South Africa

5International Centre for Reproductive Health, Ghent University, Ghent, Belgium

6Department of Psychiatry, Stellenbosch University, Cape Town, South Africa

*Corresponding Author:
Michelle Schneide
Alcohol & Drug Abuse Research Unit
Cape Town, South African
Medical Research Council, South Africa
Tel: +27 21-797-9570
Fax: +27 21-9380-0324
E-mail: [email protected]

Received Date: October 19, 2011; Accepted Date: January 25, 2012; Published Date: January 29, 2012

Citation: Schneider M, Neuman M, Chersich M,Parry C (2012) Alcohol and Antiretroviral Therapy - A Lethal Cocktail. J AIDS Clinic Res S1:005. doi:10.4172/2155-6113.S1-005

Copyright: © 2012 Schneider M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Background: Alcohol plays a role at the different points in the natural history of HIV/AIDS: This article focuses on the health implications of harmful alcohol consumption in the era of antiretroviral therapy. Aim: To explore the role of alcohol in HIV disease progression, in order to improve HIV patient management and overall better HIV prognosis. Methods: An examination of studies pertaining to the behavioral, biological and bio-chemical aspects of alcohol consumption on the pathogenesis of HIV. Findings: Alcohol consumption impacts on HIV progression resulting in increased morbidity and mortality. Alcohol consumption reduces compliance with ARV regimens, resulting in additional premature mortality. Both alcohol and HIV modulate innate and adaptive immunity and alcohol consumption for HIV-positive individuals increases the likelihood of viral replication and leads to increased susceptibility to contract opportunistic infections and other co-morbid conditions. The situation is further compounded by drugs used for the treatment of the opportunistic infections and other co-morbid conditions and their potential interactions with alcohol. The liver also metabolizes both alcohol and ARV drugs and alcohol-related liver toxicity results in compromised liver function with ARVs not working optimally and an increased risk of serious toxicity from antiretroviral therapy. Discussion: Very diverse measures of alcohol consumption have been used in studies on interactions between alcohol and HIV, making it difficult to compare studies and draw definitive conclusions. It is essential to acquire clear evidence-based guidelines on alcohol consumption for HIV-positive patients and their health-care providers. The variables alcohol, HIV and ART and their myriad interactions have not been clearly delineated. The multiple effects from HIV, alcohol and ART may compound each other, making it difficult to disentangle presenting adverse reactions and specifically the associations with alcohol. Furthermore findings in this arena are particularly relevant for prevention and treatment of HIV in countries such as South Africa that have high HIV and alcohol health burdens and have committed to an extended ARV rollout.


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