Consuming alcohol doesn’t appear to have a deleterious effect on CD4 cell counts among people living with HIV receiving antiretroviral (ARV) therapy, according to a new Johns Hopkins University study published ahead of print by the Journal of Acquired Immune Deficiency Syndromes (JAIDS). “Among individuals initiating ARV therapy,” Geetanjali Chander, MD, MPH, and his colleagues write,  “the benefits of therapy and viral suppression on the immune system outweigh detrimental effects of alcohol, reinforcing the importance of initiating [HIV treatment] and ensuring adequate adherence to therapy.”

According to the analysis of available CD4 cell count data, along with alcohol use surveys completed by more than 1,100 people living with HIV starting ARV treatment, Chander’s team found that neither the total number of drinks consumed nor the frequency of alcohol use on a weekly basis had an effect on CD4 cell counts. This held true in analyses comparing women and men, as well as those who managed to achieve and maintain undetectable viral loads compared with those who did not.

While Chander’s group concludes that people living with HIV who consume alcohol and maintain undetectable viral loads “can reap the same immunologic benefits of those who do not drink alcohol,” the authors also note some of the potential dangers of excessive drinking. They caution: “With alcohol’s negative effect on HIV medication adherence and viral suppression and its association with increased transmission behaviors”—not to mention liver toxicity, particularly among those coinfected with hepatitis C or hepatitis B—”screening for alcohol use and brief interventions encouraging reduction or abstinence in alcohol use is essential to optimize the management of HIV.”

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