Chronic alcohol use reduces CD4+counts in HIV/AIDS patients on d4T/3TC/NVP treatment regimen using WHO AUDIT tool and alcohol-use biomarkers

Abstract

Alcohol is one of the most abused drugs worldwide by people of different socio-economic status, age groups and including the HIV/AIDS patient on treatment. It is reward drug and a CNS depressant especially at high doses. The study investigated effect of chronic alcohol exposure by HIV/ AIDS patients on d4T/3TC/NVP regimen on CD4+counts inUganda using WHO AUDIT tool and chronic alcohol-use biomarkers. A longitudinal cohort using repeated measures design with serial measurements model was used. TheWHOAUDIT toolwas used to screen patients on stavudine (d4T) 30mg, lamivudine (3TC) 150mg and nevirapine (NVP) 200mg for chronic alcohol use.Atotal of 41 patients (20 alcohol group and 21 control group) were screened for chronic alcohol use. They were followed up for 9 months with blood sampling done at 3 month intervals. CD4+ count was determined using Facscalibur Flow Cytometer equipment. Results were then sorted by alcohol-use biomarkers (GGT, MCV and AST/ALT ratio). Data was analysed using SAS 2003 version 9.1 statistical package with repeatedmeasures fixedmodel and themeanswere compared using student t-test. Themean CD4+ count in all groups were lower than reference ranges at baseline and gradually increased at 3, 6 and 9 month of follow up. The mean CD4+ count in control group were higher in the control group as compared to the chronic alcohol use group in both WHO AUDIT tool group and chronic alcohol-use biomarkers group though there was no significant difference (p>0.05). Chronic alcohol use slightly lowers CD4+ cell count in HIV/AIDS patients on d4T/3TC/NVP treatment regimen.