Abstract

Chronic alcohol use affects the immune blood cell counts in HIV/AIDS patients on d4T/3TC/NVP drug regimen during the 9 months follow up period

Author(s): Godfrey S.Bbosa, David B.Kyegombe, William W.Anokbonggo, Apollo Mugisha, Jasper Ogwal-Okeng

Chronic alcohol use is a common problem globally including among HIV/ AIDS patients on ARV treatment. Ethanol and its metabolites reduce hemopoiesis and also activate HPA axis releasing cortisols that affect immune blood cell production. Study determined effect of chronic ethanol use on immune blood cell count in HIV/AIDS patients on d4T/3TC/NVP treatment for a period of 9 month follow up. A case control study using repeated measures with serial measurements model was used. Alcohol- Use biomarkers were used to standardize gender differences in alcohol use. A total of 41 patients were screened for chronic alcohol use by the WHO AUDIT tool. The 21 patients were enrolled in the control group that were not chronic alcohol users and the other 20 patients in the chronic alcohol use according to the WHO AUDIT tool scores. Since the tool was not sensitive enough the patients in the control group were again sorted out using the chronic alcohol use biomarkers. Two studies with WHO AUDIT tool group and chronic alcohol use biomarkers were done. Both groups were followed up for 9 months with blood sampling done at 3 month intervals. The immune blood cells (WBC count and differential counts) were determined using automated hematological Coulter CBC-5 Hematology Analyzer. Results were then sorted by alcohol-use biomarkers since WHO AUDIT tool was not sensitive enough to screen patients. Mean WBC counts were slightly higher at baseline and 3 month in chronic alcohol use group as compared to controls. There was variation in differential counts at different time intervals between control and chronic alcohol use for both alcohol-use biomarkers and WHO AUDIT tool groups. Generally, differential counts slightly varied between chronic alcohol use and the control groups but it was statistically insignificant (p 0.05) between the 2 groups. Chronic alcohol use by HIV/AIDS patients on d4T/ 3TC/NVP regimen reduced the mean WBC count, % lymphocytes, % monocytes and % basophils in both WHO AUDIT tool and alcohol-use biomarkers group.