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  22nd Conference on Retroviruses and
Opportunistic Infections
Seattle Washington Feb 23 - 26, 2015
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Persistently Elevated Macrophage Activation in HIV+ Women Reporting Heavy Alcohol Use (>7 drinks a week); alcohol & CVD in HIV+ VA men
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....author conclusion: Chronic heavy drinking is independently associated with HIV outcomes (CD4+ count and viral load). Persistently elevated level of sCD163 in HIV+ve heavy drinkers suggests a mediating role of macrophage activation with implications to persistent inflammation in HIV-infected women reporting heavy alcohol consumption. [HIV+ heavy drinkers (> 7 drinks/week)]
Reported by Jules Levin
CROI 2015 Feb 23-26 Seattle WA
Seema N. Desai1, Kathleen M. Weber2, Jane Burke-Miller3, Audrey L. French2, Monica Gandhi4, Mark H. Kuniholm5, Elizabeth T. Golub6, Kendall Bryant7, Alan Landay1, Mardge Cohen8
1 Department of Immunology/Microbiology, Rush University Medical Center, Chicago, IL, United States. 2 CORE Center/Stroger Hospital of Cook County, Chicago, IL, United States. 3 Hektoen Institute of Medicine, Chicago, IL, United States. 4 University of California San Francisco, San Francisco, CA, United States. 5 Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, United States. 6 Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States. 7 National Institutes of Health/National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, United States. 8Department of Medicine, Stroger Hospital of Cook County, Chicago, IL, United States.



4. Freiberg MS, McGinnis KA, Kraemer K, et al. The association between alcohol consumption and prevalent cardiovascular diseases among HIV-infected and HIV-uninfected men. J Acquir Immune Defic Syndr;53(2):247- 53.
"we found significant interaction terms suggesting that risk factors for CVD demonstrate different associations with CVD among those infected with HIV compared with uninfected individuals. These findings underscore the importance of studying actual clinical events rather than risk factors if we are to gain a better understanding of CVD risk among those with HIV infection.......In our analyses, interaction terms between HIV status and alcohol consumption, hypertension, diabetes, and current smoking were all significant suggesting that the association between hazardous alcohol consumption, alcohol abuse and dependence, and prevalent CVD is more pronounced among HIV-infected compared with uninfected individuals.......In conclusion, hazardous alcohol consumption and alcohol abuse or dependence were associated with an increased prevalence of CVD among HIV-infected veterans compared with infrequent and moderate alcohol consumption. This association persisted even after adjustment for traditional CVD risk factors, HIV-related risk factors including HCV, use of and adherence to ART, and CD4 count. This association did not reach significance among uninfected demographically similar comparators suggesting that the effect of alcohol may be more pronounced among those infected with HIV.......
We also ran models adjusted for traditional CVD risk factors predicting CHD, CHF, and stroke for HIV-infected and HIV-uninfected veterans. Among HIV-infected veterans, hazardous drinking was statistically significantly associated with CHF (OR = 1.74, 95% CI = 1.04 to 2.91); alcohol abuse or dependence was significantly associated with CHD (OR = 1.67, 95% CI = 1.06 to 2.64) and CHF (OR = 1.99, 95% CI = 1.12 to 3.55); and past drinking was significantly associated with stroke (OR = 1.97, 95% CI = 1.30 to 2.98). Among HIV-uninfected veterans, there were no statistically significant associations between hazardous alcohol consumption and alcohol abuse or dependence and CHD, CHF, or stroke. However, past drinking was statistically significantly associated with stroke (OR = 1.78, 95% CI = 1.24 to 2.54 (data not otherwise shown)."
"we categorized alcohol into 3 groups: infrequent and moderate, hazardous, and abuse or dependence. Infrequent and moderate drinkers were combined to form the referent group. Using the National Institute on Alcoholism and Alcohol Abuse guidelines, we defined infrequent or moderate drinking as consuming ≤14 drinks per week and no binge drinking. Hazardous drinking was defined as >14 drinks per week or binge drinking.22 Alcohol abuse or dependence was defined using ICD-9 codes based on prior work in the VACS.23 Importantly, if a participant was a moderate drinker by self-report, but had an ICD-9 code documenting alcohol abuse or dependence, this participant was included in the alcohol abuse and dependent category. We defined past drinkers as those who had consumed ≥1 drink in their lifetime but responded “more than 12 months ago” to the question, “When was the last time you had a drink?” As stated earlier, lifetime abstainers were excluded."