Causal Considerations on Alcohol and HIV/AIDS - A Systematic Review
Causal Considerations on Alcohol and HIV/AIDS - A Systematic Review
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DOI：
10.1093/alcalc/agp091
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发表时间：
2010-03-01
影响因子：
2.8
通讯作者：
Rehm, Juergen
中科院分区：
文献类型：
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作者：
Shuper, Paul A.;Neuman, Manuela;Rehm, Juergen
研究方法：根据标准流行病学标准进行了一项基于荟萃分析和综述的综述，以区分因果关系和相关性，检查（i）酒精对艾滋病毒发病率的潜在影响和（ii）酒精对疾病进程恶化的影响。结果如下：就艾滋病毒的发病率而言，尽管我们发现了与消费的一致和强烈的关联，但没有足够的证据表明因果关系。特别是，目前尚不清楚是否人格特质，如感觉寻求或性强迫和精神疾病，如反社会人格障碍，影响酒精消费和危险性行为，随后创建两种行为之间的关联。就艾滋病毒/艾滋病的病程恶化而言，我们发现了足够的证据证明酒精的因果影响。酒精影响免疫系统，从而导致艾滋病毒/艾滋病的恶化。此外，酒精对包括寻求支持和药物依从性在内的行为产生负面影响。结论：一项针对居住在艾滋病高发地区的高危艾滋病病毒阴性个体的随机对照临床试验被建议用于测试已被证明有效的酒精干预对艾滋病发病率的影响。
Methods: A review based on meta-analyses and reviews was conducted according to standard epidemiological criteria to distinguish causality from association, examining (i) the potential impact of alcohol on the incidence of HIV and (ii) alcohol's impact on worsening the disease course. Results: In terms of incidence of HIV, although we found a consistent and strong association with consumption, there was not enough evidence for a causal connection. In particular, it is not clear whether personality traits such as sensation seeking or sexual compulsivity and psychiatric disorders such as antisocial personality disorder impact both alcohol consumption and risky sex, subsequently creating an association between both behaviors. In terms of worsening the disease course of HIV/AIDS, we found enough evidence for a causal impact of alcohol. Alcohol affects the immune system, thus contributing to a worsened course of HIV/AIDS. In addition, alcohol negatively impacts on behaviors that include support seeking and medication adherence. Conclusions: A randomized controlled clinical trial targeted toward at-risk HIV-negative individuals who live in areas with high HIV prevalence is suggested to test the effects of proven effective alcohol interventions on HIV incidence.