Alcohol use and immune reconstitution among HIV-infected patients on antiretroviral therapy in Nairobi, Kenya

Anthony Cagle, Christine McGrath, Barbra A. Richardson, Dennis Donovan, Sameh Sakr, Nelly Yatich, Richard Ngomoa, Agnes Chepngeno Langat, Grace John-Stewart, Michael H. Chung

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1-6
Number of pages6
JournalAIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
DOIs
StateAccepted/In press - Jan 31 2017

Fingerprint

Kenya
CD4 Lymphocyte Count
alcohol
Alcohols
HIV
alcohol consumption
Alcohol Drinking
Therapeutics
Drinking
Linear Models
Alcoholic Beverages
alcoholism
Social Class
Disease Progression
social status
Cohort Studies
Retrospective Studies
Disease
Education
regression

Keywords

  • Africa
  • alcohol
  • antiretroviral therapy
  • CD4 count
  • HIV

ASJC Scopus subject areas

  • Health(social science)
  • Social Psychology
  • Public Health, Environmental and Occupational Health

Cite this

Alcohol use and immune reconstitution among HIV-infected patients on antiretroviral therapy in Nairobi, Kenya. / Cagle, Anthony; McGrath, Christine; Richardson, Barbra A.; Donovan, Dennis; Sakr, Sameh; Yatich, Nelly; Ngomoa, Richard; Chepngeno Langat, Agnes; John-Stewart, Grace; Chung, Michael H.

In: AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV, 31.01.2017, p. 1-6.

Research output: Contribution to journalArticle

Cagle, A, McGrath, C, Richardson, BA, Donovan, D, Sakr, S, Yatich, N, Ngomoa, R, Chepngeno Langat, A, John-Stewart, G & Chung, MH 2017, 'Alcohol use and immune reconstitution among HIV-infected patients on antiretroviral therapy in Nairobi, Kenya', AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV, pp. 1-6. https://doi.org/10.1080/09540121.2017.1281881
Cagle, Anthony ; McGrath, Christine ; Richardson, Barbra A. ; Donovan, Dennis ; Sakr, Sameh ; Yatich, Nelly ; Ngomoa, Richard ; Chepngeno Langat, Agnes ; John-Stewart, Grace ; Chung, Michael H. / Alcohol use and immune reconstitution among HIV-infected patients on antiretroviral therapy in Nairobi, Kenya. In: AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV. 2017 ; pp. 1-6.
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