Chronic alcohol use reduces CD4+cell count in HIV-infected Ugandan patients on d4T/3TC/NVP treatment regimen

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

Alcohol is one of the most abused drugs worldwide by people of different socio-economic status, age groups and including the HIV-infected patient on treatment. It is reward drug and a CNS depressant especially at high doses. The study investigated effect of chronic alcohol exposure by HIVinfected patients on d4T/3TC/NVP regimen on CD4+counts in Uganda usingWHOAUDIT tool and chronic alcohol-use biomarkers.Alongitudinal 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 by WHO AUDIT tool and chronic alcohol use biomarkers. They were followed up for 9 months with blood sampling done at 3 month intervals. CD4+ count was determined using Facscalibur Flow Cytometer system. Results were then sorted by alcohol-use biomarkers (GGT,MCVandAST/ALT ratio).Datawas analysed using SAS 2003 version 9.1 statistical package with repeated measures fixed model and the means were compared using student t-test. The mean CD4+ count in all groups were lower than reference ranges at baseline and gradually increased at 3, 6 and 9month of followup. Themean 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 HIVinfected patients on d4T/3TC/NVP treatment regimen.

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