Yale University School of Medicine, Department of Medicine, Section of Infectious Diseases, AIDS Program, 135 College Street, Suite 323, New Haven 06511, CT, USA.
Drug Alcohol Depend. 2010 Dec 1;112(3):178-93. doi: 10.1016/j.drugalcdep.2010.06.014. Epub 2010 Aug 11.
Alcohol use disorders (AUDs) are highly prevalent and associated with non-adherence to antiretroviral therapy, decreased health care utilization and poor HIV treatment outcomes among HIV-infected individuals.
To systematically review studies assessing the impact of AUDs on: (1) medication adherence, (2) health care utilization and (3) biological treatment outcomes among people living with HIV/AIDS (PLWHA).
Six electronic databases and Google Scholar were queried for articles published in English, French and Spanish from 1988 to 2010. Selected references from primary articles were also examined.
Selection criteria included: (1) AUD and adherence (N=20); (2) AUD and health services utilization (N=11); or (3) AUD with CD4 count or HIV-1 RNA treatment outcomes (N=10). Reviews, animal studies, non-peer reviewed documents and ongoing studies with unpublished data were excluded. Studies that did not differentiate HIV+ from HIV- status and those that did not distinguish between drug and alcohol use were also excluded. Data were extracted, appraised and summarized.
Our findings consistently support an association between AUDs and decreased adherence to antiretroviral therapy and poor HIV treatment outcomes among HIV-infected individuals. Their effect on health care utilization, however, was variable.
酒精使用障碍（AUD）在 HIV 感染者中非常普遍，与抗逆转录病毒治疗的不依从、卫生保健利用率降低和 HIV 治疗结局不佳有关。
系统回顾评估 AUD 对 HIV 感染者的以下方面的影响：（1）药物依从性；（2）卫生保健利用率；（3）生物学治疗结局的研究。
从 1988 年至 2010 年，检索了六个电子数据库和 Google Scholar 中发表的英文、法文和西班牙文文献。还查阅了主要文章的参考文献。
选择标准包括：（1）AUD 和依从性（N=20）；（2）AUD 和卫生服务利用率（N=11）；或（3）AUD 与 CD4 计数或 HIV-1 RNA 治疗结局（N=10）。排除综述、动物研究、非同行评审文件和正在进行的未公布数据的研究。未区分 HIV+和 HIV-状态的研究以及未区分药物和酒精使用的研究也被排除在外。提取、评估和总结数据。
我们的研究结果一致支持 AUD 与 HIV 感染者抗逆转录病毒治疗依从性降低和 HIV 治疗结局不佳之间存在关联。然而，它们对卫生保健利用率的影响是可变的。
