Asiimwe Stephen B, Fatch Robin, Patts Gregory, Winter Michael, Lloyd-Travaglini Christine, Emenyonu Nneka, Muyindike Winnie, Kekibiina Allen, Blokhina Elena, Gnatienko Natalia, Kruptisky Evgeny, Cheng Debbie M, Samet Jeffrey H, Hahn Judith A
Department of Medicine, Mbarara Regional Referral Hospital, Mbarara, Uganda.
Department of Epidemiology and Biostatistics, University of California San Francisco, 550 16th Street, 2nd floor, Mission Hall: Global Health and Clinical Sciences Building, San Francisco, CA, 94158, USA.
AIDS Behav. 2017 Nov;21(Suppl 2):204-215. doi: 10.1007/s10461-017-1895-2.
In HIV-infected drinkers, alcohol types more likely to cause inflammation could plausibly increase the risk of HIV disease progression. We therefore assessed the association between alcohol type and plasma HIV RNA level (HIV viral load) among HIV-infected drinkers not on antiretroviral therapy (ART) in Russia and Uganda. We analyzed the data of participants from cohorts in Russia and Uganda and assessed their HIV viral load at enrollment by the alcohol type predominantly consumed. We defined predominant alcohol type as the alcohol type contributing >50% of total alcohol consumption in the 1 month (Russia) or 3 months (Uganda) prior to enrollment. Using multiple linear regression, we compared log HIV viral load by predominant alcohol type, controlling for age, gender, socioeconomic status, total number of standard drinks, frequency of drinking ≥6 drinks/occasion, and in Russia, history of injection drug use. Most participants (99.2% of 261 in Russia and 98.9% of 352 in Uganda) predominantly drank one alcohol type. In Russia, we did not find evidence for differences in viral load levels between drinkers of fortified wine (n = 5) or hard liquor (n = 49), compared to drinkers of beer/low-ethanol-content cocktails (n = 163); however, wine/high-ethanol-content cocktail drinkers (n = 42) had higher mean log viral load than beer/low-ethanol-content cocktail drinkers (β = 0.38, 95% CI 0.07-0.69; p = 0.02). In Uganda, we did not find evidence for differences in viral load levels between drinkers of locally-brewed beer (n = 41), commercially-distilled spirits (n = 38), or locally-distilled spirits (n = 43), compared to drinkers of commercially-made beer (n = 218); however, wine drinkers (n = 8) had lower mean log HIV viral load (β = -0.65, 95% CI -1.36 to 0.07, p = 0.08), although this did not reach statistical significance. Among HIV-infected drinkers not yet on ART in Russia and Uganda, we observed an association between the alcohol type predominantly consumed and the HIV viral load level in the Russia sample. These exploratory results suggest that, in addition to total number of drinks and drinking patterns, alcohol type might be a dimension of alcohol use that merits examination in studies of HIV and alcohol related outcomes.
在感染HIV的饮酒者中，更易引发炎症的酒精类型可能会增加HIV疾病进展的风险。因此，我们评估了俄罗斯和乌干达未接受抗逆转录病毒治疗（ART）的感染HIV饮酒者中酒精类型与血浆HIV RNA水平（HIV病毒载量）之间的关联。我们分析了来自俄罗斯和乌干达队列参与者的数据，并根据其主要饮用的酒精类型评估了他们入组时的HIV病毒载量。我们将主要酒精类型定义为在入组前1个月（俄罗斯）或3个月（乌干达）内占酒精总摄入量>50%的酒精类型。使用多元线性回归，我们比较了主要酒精类型的对数HIV病毒载量，并控制了年龄、性别、社会经济地位、标准饮酒总量、每次饮用≥6杯酒的频率，以及在俄罗斯的注射吸毒史。大多数参与者（俄罗斯261人中的99.2%和乌干达352人中的98.9%）主要饮用一种酒精类型。在俄罗斯，与饮用啤酒/低乙醇含量鸡尾酒的人（n = 163）相比，我们没有发现饮用强化葡萄酒的人（n = 5）或烈性酒的人（n = 49）在病毒载量水平上存在差异的证据；然而，饮用葡萄酒/高乙醇含量鸡尾酒的人（n = 42）的平均对数病毒载量高于饮用啤酒/低乙醇含量鸡尾酒的人（β = 0.38，95% CI 0.07 - 0.69；p = 0.02）。在乌干达，与饮用商业酿造啤酒的人（n = 218）相比，我们没有发现饮用当地酿造啤酒的人（n = 41）、商业蒸馏烈酒的人（n = 38）或当地蒸馏烈酒的人（n = 43）在病毒载量水平上存在差异的证据；然而，饮用葡萄酒的人（n = 8）的平均对数HIV病毒载量较低（β = -0.65，95% CI -1.36至0.07，p = 0.08），尽管这未达到统计学显著性。在俄罗斯和乌干达尚未接受ART治疗且感染HIV的饮酒者中，我们在俄罗斯样本中观察到主要饮用的酒精类型与HIV病毒载量水平之间存在关联。这些探索性结果表明，除了饮酒总量和饮酒模式外，酒精类型可能是酒精使用的一个维度，在HIV与酒精相关结局的研究中值得探讨。
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