The influence of different types of alcoholic beverages on disrupting highly active antiretroviral treatment (HAART) outcome.
The influence of different types of alcoholic beverages on disrupting highly active antiretroviral treatment (HAART) outcome.
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不同类型的酒精饮料对破坏高效抗逆转录病毒治疗 (HAART) 结果的影响。
DOI：
10.1093/alcalc/agp024
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发表时间：
2009
期刊：
影响因子：
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通讯作者：
Malow,RobertM
中科院分区：
文献类型：
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作者：
Míguez-Burbano,MaríaJosé;Lewis,JohnE;Fishman,Joel;Asthana,Deshratn;Malow,RobertM
目的：关于酒精对艾滋病毒预后的影响，特别是在高效抗逆转录病毒治疗（HAART）后，研究得出了相互矛盾的结果。不同的发现可能与混杂变量有关，包括性别、酒精滥用模式和酒精饮料的类型。方法：采用一项队列研究，比较治疗24周后HAART疗效的差异与饮酒量和偏好、仅饮用白酒（LI,n= 55）或仅饮用葡萄酒或啤酒（BW,n= 110）的关系。鉴于胸腺在HAART反应中的关键作用，我们评估了胸腺大小、CD4s、naïve淋巴细胞和病毒载量的变化。结果：经HAART治疗后，BW组cd4（+12个细胞计数/mm3）和胸腺大小（+0.7 mm3）均明显增加。相比之下，LI亚组在这两个参数（- 4 CD4细胞/mm3和- 0.6 mm3胸腺大小）上都表现出下降。LI组女性CD4（163.4±46.2）和naïve计数（178±69.5）明显低于LI组男性（CD4: 281.6±203，P= 0.05；淋巴细胞：301.4±198，P= 0.04）。在调整后的回归模型中，与BW亚组相比，LI亚组维持可检测病毒载量的几率更大（RR = 1.35, 95% CI 1.04-1.75；P= 0.03），胸腺体积增加（RR = 3.8，P= 0.04）， naïve细胞补充（RR = 13，P= 0.02）。结论：酒精与HAART后胸腺恶化相关，从而导致较差的病毒免疫结果。通过饮酒模式对参与者进行分型似乎与临床相关，需要在未来的研究中加以考虑。
Aims:Studies have yielded conflicting results regarding alcohol's influence on HIV outcomes, particularly after highly active antiretroviral treatment (HAART). Discrepant findings may be related to confounding variables, including gender, patterns of alcohol abuse and type of alcohol beverage beyond the amount consumed.Methods:Using a cohort study, differences in HAART effectiveness after 24 weeks of therapy were compared as a function of amount and preference for alcohol, drinking only liquor (LI,n= 55) or only wine or beer (BW,n= 110). Given the critical role of thymus on HAART response, changes in thymus size, CD4s, naïve lymphocytes and viral loads were assessed.Results:After HAART, positive increases in both CD4s (+12 cell counts/mm3) and thymus size (+0.7 mm3) were evident in the BW group. In contrast, the LI subgroup exhibited a decline in both parameters (−4 CD4 cells/mm3and −0.6 mm3in thymus size). Women in the LI group exhibited significantly lower CD4 (163.4 ± 46.2) and naïve counts (178 ± 69.5) than LI men (CD4: 281.6 ± 203,P= 0.05; lymphocytes: 301.4 ± 198,P= 0.04). In adjusted regression models, the LI compared to the BW subgroup had greater odds of maintaining detectable viral loads (RR = 1.35, 95% CI 1.04–1.75;P= 0.03), increased thymus volumes (RR = 3.8,P= 0.04) and replenished naïve cells (RR = 13,P= 0.02).Conclusions:Liquor was associated with thymus deterioration and thus with poorer viro-immune outcomes after HAART. Subtyping participants by alcohol consumption patterns seems to be clinically relevant and needs to be accounted for in future studies.