Alcohol and HIV Disease Progression: Weighing the Evidence

Heavy alcohol use is commonplace among HIV-infected individuals; however, the extent that alcohol use adversely impacts HIV disease progression has not been fully elucidated. Fairly strong evidence suggests that heavy alcohol consumption results in behavioral and biological processes that likely increase HIV disease progression, and experimental evidence of the biological effect of heavy alcohol on simian immunodeficiency virus in macaques is quite suggestive. However, several observational studies of the effect of heavy alcohol consumption on HIV progression conducted in the 1990s found no association of heavy alcohol consumption with time to AIDS diagnosis, while some more recent studies showed associations of heavy alcohol consumption with declines of CD4 cell counts and nonsuppression of HIV viral load. We discuss several plausible biological and behavioral mechanisms by which alcohol may cause HIV disease progression, evidence from prospective observational human studies, and suggest future research to further illuminate this important issue.

• Publication year

  2010

• Venue

  Current HIV/AIDS Reports

• Publication date

  2010-09-03

• Fields of study

  Medicine

• Identifiers
  DOI 10.1007/s11904-010-0060-6PMID 20814765PMCID 2938419
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

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  2008cited by this paper
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  2008cited by this paper
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  2008cited by this paper
• Alcohol Consumption and HIV Disease Progression

  2007cited by this paper
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  2007cited by this paper
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  2007cited by this paper
• Chronic binge ethanol consumption accelerates progression of simian immunodeficiency virus disease.

  2006cited by this paper
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  2006cited by this paper
• Chronic alcohol accentuates nutritional, metabolic, and immune alterations during asymptomatic simian immunodeficiency virus infection.

  2006cited by this paper
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  2006cited by this paper
• Chronic Alcohol Consumption Results in Higher Simian Immunodeficiency Virus Replication in Mucosally Inoculated Rhesus Macaques

  2005cited by this paper
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  2005cited by this paper
• A temporal and dose-response association between alcohol consumption and medication adherence among veterans in care.

  2005cited by this paper
• Increased Viral Replication in Simian Immunodeficiency Virus/Simian-HIV-Infected Macaques With Self-Administering Model of Chronic Alcohol Consumption

  2005cited by this paper
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  2005cited by this paper
• Micronutrients and HIV disease: a review pre- and post-HAART.

  2005cited by this paper
• Late presenters in the era of highly active antiretroviral therapy: uptake of and responses to antiretroviral therapy

  2004cited by this paper
• Alcohol consumption and antiretroviral adherence among HIV-infected persons with alcohol problems.

  2004cited by this paper
• Analysis of longitudinal marginal structural models.

  2004cited by this paper
• How harmful is hazardous alcohol use and abuse in HIV infection: do health care providers know who is at risk?

  2003cited by this paper
• Weight loss and survival in HIV-positive patients in the era of highly active antiretroviral therapy.

  2002cited by this paper
• The prevalence of alcohol consumption and heavy drinking among people with HIV in the United States: results from the HIV Cost and Services Utilization Study.

  2002cited by this paper
• Influence of Highly Active Antiretroviral Therapy on Micronutrient Profiles in HIV-Infected Patients

  2000cited by this paper
• A prospective study of HIV disease progression in female and male drug users.

  1999influential reference
• Consequences of alcohol consumption on host defence.

  1999cited by this paper
• Synergism of nutrition, infection, and immunity: an overview.

  1997cited by this paper
• Low serum vitamin B-12 concentrations are associated with faster human immunodeficiency virus type 1 (HIV-1) disease progression.

  1997cited by this paper
• Alcohol use and T-lymphocyte subsets among injection drug users with HIV-1 infection: a prospective analysis.

  1996cited by this paper
• Alcohol consumption as a cofactor in the progression of HIV infection and AIDS.

  1995cited by this paper
• Determinants of HIV disease progression among homosexual men registered in the Tricontinental Seroconverter Study.

  1994cited by this paper
• Cigarette Smoking and Drinking of Alcohol are not Associated with Rapid Progression to Acquired Immunodeficiency Syndrome among Homosexual Men in Norway

  1994cited by this paper
• Medical and Nutritional Complications of Alcoholism

  1992cited by this paper
• Role of alcohol abuse in nutritional immunosuppression.

  1992cited by this paper
• Risk factors for progression of human immunodeficiency virus (HIV) infection among seroconverted and seropositive homosexual men.

  1990cited by this paper
• No evidence for a role of alcohol or other psychoactive drugs in accelerating immunodeficiency in HIV-1-positive individuals. A report from the Multicenter AIDS Cohort Study.

  1989cited by this paper
• Hepatic microsomal ethanol-oxidizing system. In vitro characteristics and adaptive properties in vivo.

  1970cited by this paper

• Economic and relationship-strengthening intervention to reduce alcohol use in couples living with HIV in Malawi: a study protocol for a randomised controlled trial of Mlambe

  2025cites this paper
• Pilot Results of Masibambisane: Couples Motivational Interviewing with Mobile Breathalyzers to Address Unhealthy Drinking and Adherence to Antiretroviral Therapy in South Africa

  2025cites this paper
• “After reducing alcohol, things now work well at home”: Perceived impacts of the Mlambe intervention on alcohol use, relationship dynamics, household economics, and HIV treatment adherence in Malawian couples

  2025cites this paper
• Contextual factors and implementation strategies for a biomarker-augmented alcohol screening with brief intervention and referral to treatment (SBIRT) program for HIV-affected adolescents in Zambia: a qualitative study guided by RE-AIM / PRISM

  2025cites this paper
• Healthcare Provider Perceptions on Screening and Treatment for Unhealthy Alcohol Use in HIV Primary Care Settings.

  2025cites this paper
• Mlambe economic and relationship-strengthening intervention for alcohol use decreases violence and improves relationship quality in couples living with HIV in Malawi.

  2024cites this paper
• Pilot Trial Results of Mlambe: An Economic and Relationship-Strengthening Intervention to Address Heavy Drinking and Adherence to Antiretroviral Therapy in Malawi

  2024cites this paper
• Substance use disorder: Epidemiology, medical consequences and treatment.

  2024cites this paper
• COVID-19 Breakthrough Infection after Vaccination and Substance Use Disorders: A Longitudinal Cohort of People with and without HIV Receiving Care in the United States Veterans Health Administration

  2024cites this paper
• Pharmacotherapy for alcohol use disorder among adults with medical disorders in Sweden

  2024cites this paper
• Nutritional and Lifestyle Therapy for NAFLD in People with HIV

  2023cites this paper
• HIV and its associated factors among people who inject drugs in Mizoram, Northeast India

  2023cites this paper
• Alcohol consumption and HIV disease prognosis among virally unsuppressed in Rural KwaZulu Natal, South Africa

  2023cites this paper
• Association of Alcohol Consumption With CD4 Recovery After Antiretroviral Therapy Initiation in St. Petersburg, Russia

  2023cites this paper
• Potential risk factors for cardiovascular diseases and associated sociodemographic characteristics: A cross-sectional evaluation of a large cohort of women living with HIV in north-central Nigeria

  2023cites this paper
• Impact of alcohol use disorder severity on human immunodeficiency virus (HIV) viral suppression and CD4 count in three international cohorts of people with HIV.

  2023cites this paper
• Estimating the changing burden of disease attributable to alcohol use in South Africa for 2000, 2006 and 2012.

  2022cites this paper
• Self-Management Frameworks for Youth Living with Human Immunodeficiency Virus.

  2022cites this paper
• Concordance Between Point-of-Care Urine Ethyl Glucuronide Alcohol Tests and Self-Reported Alcohol Use in Persons with HIV in Uganda

  2022cites this paper
• Prenatal and adolescent alcohol exposure programs immunity across the lifespan: CNS-mediated regulation.

  2022cites this paper
• Development of an Economic and Relationship-Strengthening Intervention for Alcohol Drinkers Living with HIV in Malawi

  2022cites this paper
• HIV and Mental Health in Men

  2021cites this paper
• Use of methamphetamine and alcohol among people with opioid use disorder and HIV in Vietnam: a qualitative study

  2021cites this paper
• FRAX assessment in people ageing with HIV

  2021cites this paper
• Post-traumatic stress disorder among persons with HIV who engage in heavy alcohol consumption in southwestern Uganda

  2021cites this paper
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  2021cites this paper
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  2021cites this paper
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  2021cites this paper
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  2021cites this paper
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  2021cites this paper
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  2021cites this paper
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  2021cites this paper
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  2021cites this paper
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  2021cites this paper
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  2021cites this paper
• Possible Mechanisms of HIV Neuro-Infection in Alcohol Use: Interplay of Oxidative Stress, Inflammation, and Energy Interruption.

  2021cites this paper
• Mental Health Mediates the Association Between Gender-Based Violence and HIV Treatment Engagement in US Women

  2021cites this paper
• Alcohol Use and the Risk of Communicable Diseases

  2021cites this paper
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  2021cites this paper
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  2020cites this paper
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  2020cites this paper
• Neuroimaging and Cognitive Evidence for Combined HIV-Alcohol Effects on the Central Nervous System: A Review.

  2020cites this paper
• Comprehensive Assessment of Alcohol Consumption in People Living with HIV (PLWH): The New Orleans Alcohol Use in HIV Study.

  2020influential citation
• Common Elements Treatment Approach (CETA) for unhealthy alcohol use among persons with HIV in Zambia: Study protocol of the ZCAP randomized controlled trial

  2020cites this paper
• A systematic review of interventions for reducing heavy episodic drinking in sub-Saharan African settings

  2020cites this paper
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  2020cites this paper
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  2020cites this paper
• Cocaine Use: A Threat for the HIV-Infected Liver

  2020cites this paper
• An Integrative Review

  2019influential citation
• ‘What will it take’: addressing alcohol use among people living with HIV in South Africa

  2019cites this paper
• HIV Infection, HCV Coinfection, and Alcohol Use: Associations with Microbial Translocation and Immune Activation.

  2019cites this paper
• HIV care provider perceptions and approaches to managing unhealthy alcohol use in primary HIV care settings: a qualitative study

  2019cites this paper
• Fatty liver disease in persons with HIV infection.

  2019cites this paper
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  2019cites this paper
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  2019cites this paper
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  2019cites this paper
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  2019cites this paper
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  2019cites this paper
• Reduction in Drinking was Associated With Improved Clinical Outcomes in Women With HIV Infection and Unhealthy Alcohol Use: Results From a Randomized Clinical Trial of Oral Naltrexone Versus Placebo.

  2019cites this paper
• Differences in Receipt of Alcohol-Related Care Across Rurality Among VA Patients Living With HIV With Unhealthy Alcohol Use.

  2019cites this paper
• Substance use Patterns and HIV-1 RNA Viral Load Rebound among HIV-Positive Illicit Drug users in a Canadian Setting

  2019cites this paper
• Associations of Liver Disease with Alcohol Use among People Living with HIV and the Role of Hepatitis C: The New Orleans Alcohol Use in HIV Study.

  2019cites this paper
• Is physician assessment of alcohol consumption useful in predicting risk of severe liver disease among people with HIV and HIV/HCV co-infection?

  2019cites this paper
• Liver fibrosis and accelerated immune dysfunction (immunosenescence) among HIV-infected Russians with heavy alcohol consumption - an observational cross-sectional study

  2019cites this paper
• Considering high alcohol and violence neighborhood context using daily diaries and GPS: A pilot study among people living with HIV.

  2018cites this paper
• Alcohol Use and HIV Disease Progression in an Antiretroviral Naive Cohort

  2018cites this paper
• Imaging studies of the HIV-infected brain.

  2018cites this paper
• Racial/ethnic differences in the association between alcohol use and mortality among men living with HIV

  2018cites this paper
• A qualitative study on alcohol consumption and HIV treatment adherence among men living with HIV in Ugandan fishing communities

  2018influential citation
• The association between HIV clinical disease severity and psychiatric disorders as seen in Western Romania

  2018cites this paper
• The Depression Treatment Cascade: Disparities by Alcohol Use, Drug Use, and Panic Symptoms Among Patients in Routine HIV Care in the United States

  2018cites this paper
• Patterns of Alcohol Use Among Patients Living With HIV in Urban, Large Rural, and Small Rural Areas.

  2018cites this paper
• HIV-Related Stigma and Viral Suppression Among African-American Women: Exploring the Mediating Roles of Depression and ART Nonadherence

  2018cites this paper
• Testosterone deficiency in non-cancer opioid-treated patients

  2018cites this paper
• Addressing unhealthy alcohol use among people living with HIV: recent advances and research directions

  2018cites this paper
• Association between change in self-efficacy to resist drinking and drinking behaviors among an HIV-infected sample: Results from a large randomized controlled trial

  2018cites this paper
• Changes in alcohol use associated with changes in HIV disease severity over time: A national longitudinal study in the Veterans Aging Cohort.

  2018cites this paper
• Impact of Alcohol on HIV Disease Pathogenesis, Comorbidities and Aging: Integrating Preclinical and Clinical Findings.

  2018cites this paper
• Level of Alcohol Use Associated with HIV Care Continuum Targets in a National U.S. Sample of Persons Living with HIV Receiving Healthcare

  2018cites this paper
• Efficacy of Extended-Release Naltrexone on HIV-Related and Drinking Outcomes Among HIV-Positive Patients: A Randomized-Controlled Trial

  2018cites this paper
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  2018cites this paper
• The Relationships between Cholesterol, Tobacco and Alcohol Use : A New Opportunity for Intervention among People Living with HIV

  2018cites this paper
• Role of substance use in HIV care cascade outcomes among people who inject drugs in Russia

  2017cites this paper
• HIV Stigma and Substance Use Among HIV-Positive Russians with Risky Drinking

  2017cites this paper
• Alcohol Use, HIV Treatment Adherence, and Sexual Risk Among People with a History of Injecting Drug Use in Vietnam

  2017cites this paper
• Alcohol Types and HIV Disease Progression Among HIV-Infected Drinkers Not Yet on Antiretroviral Therapy in Russia and Uganda

  2017cites this paper
• Psychosocial stressors and alcohol use, severity, and treatment receipt across human immunodeficiency virus (HIV) status in a nationally representative sample of US residents

  2017influential citation
• Does alcohol use have a causal effect on HIV incidence and disease progression? A review of the literature and a modeling strategy for quantifying the effect

  2017cites this paper
• Acceptability and feasibility of a randomized clinical trial of oral naltrexone vs. placebo for women living with HIV infection: Study design challenges and pilot study results.

  2017cites this paper
• Among patients with unhealthy alcohol use, those with HIV are less likely than those without to receive evidence-based alcohol-related care: A national VA study.

  2017cites this paper
• The association between substance use and sub-optimal HIV treatment engagement among HIV-infected female sex workers in Lilongwe, Malawi

  2017cites this paper
• Hazardous alcohol consumption is not associated with CD4+ T-cell count decline among PLHIV in Kampala Uganda: A prospective cohort study

  2017cites this paper
• Alcohol and substance use diagnoses among HIV-positive patients receiving care in NYC clinic settings.

  2017cites this paper
• At‐Risk Alcohol Use is Associated with Antiretroviral Treatment Nonadherence Among Adults Living with HIV/AIDS

  2017cites this paper
• Alcohol Use, Socioeconomic Status and Risk of HIV Infections

  2017cites this paper
• The relationship between different dimensions of alcohol use and the burden of disease—an update

  2017cites this paper
• Association between alcohol consumption and injection and sexual risk behaviors among people who inject drugs in rural Puerto Rico.

  2017cites this paper
• Long-term alcohol use patterns and HIV disease severity.

  2017cites this paper