Alcohol Use in Early Stages of HIV

Study Utilizes Innovative Method for Detecting Alcohol Use in HIV Patients in sub-Saharan Africa

As international guidelines for when to start people on HIV treatment have shifted, new UMD-led research investigates whether alcohol use could impede the effects of antiretroviral therapy (ART) for patients in sub-Saharan Africa in the early stages of the disease.

Previously, ART was given only to HIV patients with lower immune functioning, but recent universal access initiatives may put an additional 23 million people with HIV into treatment while they are still relatively healthy.

“Unhealthy alcohol use is a known risk factor for contracting HIV, but also a barrier for successful treatment outcomes,” explained Jessica Magidson, an assistant professor of psychology at UMD, who led the research. “We surmised that for people starting HIV treatment in earlier phases—when they are largely asymptomatic and feel healthier—alcohol use might be more of an issue.”

To test this theory, Magidson and a team of researchers from the University of California San Francisco, Harvard Medical School, as well as universities in South Africa and Uganda, used a biomarker to evaluate alcohol use among 401 patients in South Africa and Uganda beginning HIV treatment at different disease stages. The specific biomarker utilized in the study is called phosphatidylethanol, or PEth, and can be extracted from dried blood samples. Formed only in the presence of alcohol use, PEth is detectable within two to three weeks of alcohol consumption.

Results of the study, published in AIDS and Behavior, found high rates of unhealthy alcohol use in nearly a third of the participants regardless of disease stage. Researchers say their findings point to the need for alcohol use intervention to be integrated into HIV care, especially as access to treatments expands globally.

“More than 7 million people are living with HIV in South Africa alone and alcohol is a substantial burden in this population,” Magidson said. “Our study is one of the first efforts to use this biomarker of alcohol use among people with the virus in South Africa and obstacles such as cost and access to specialized laboratories currently prevent the widespread use of this method. However, we must do more to accurately assess and address alcohol use and its impact on this disease.”

The research team is now leading an ongoing clinical trial based in Cape Town, South Africa to evaluate effective models for integrating alcohol use interventions into HIV care.

The present study was funded by the Gates Foundation and the National Institute of Drug Abuse.

Published on Thu, Mar 28, 2019 - 12:39PM