Kenya: Study - Alcohol Can Speed Up Aids Progression

By Albert Muriuki, Business Daily
30/08/2007

Nairobi - Kenya may lose the gains it has made against HIV due to rampant alcoholism among the infected, a new research on the impact of alcohol on management of the pandemic indicates.

The study by the University of Boston found that heavy consumption of alcohol speeds up the onset of Aids in those infected by HIV.

"The impact is most pronounced in HIV patients who are not on anti-retroviral therapy (ART)," said Jeffrey Samet of Boston University.

The study, however, suggests that HIV patients who avoid alcohol consumption have higher chances of living longer than their counterparts who consume alcohol. "HIV-infected persons who drink heavily and are not on ART can decrease the risk of disease progression if they abstain from alcohol," said Dr Boston.

The findings emerged from two studies that ran consecutively from 1997 through 2001 and 2001 through 2006, to investigate links between alcohol use and HIV progression.

Dr Armstrong Mwenda, a government doctor in Kiambu, said the findings largely reflect the Kenyan situation where HIV-infected persons who drink heavily have succumbed to Aids faster than those who do not drink.

The Boston researchers defined heavy drinking as more than 14 drinks a week or at least five bottles of beer on a single occasion for men younger than 66.

For men who are 66 years or older, more than seven drinks a week or at least four bottles of beer on a single occasion was considered heavy while for women, consumption of more than seven bottles of beer a week or at least four on a single occasion is considered heavy.

Moderate alcohol use was defined as any drinking less than heavy amounts.

Participants were assessed every six months for CD4 cell counts and HIV RNA levels and for alcohol use within the previous 30 days.

Overall, the researchers said, 30 per cent of participants were heavy consumers, 10 per cent were moderate, and 59 per cent were abstinent. Among those who reported drinking in the 30 days before an assessment, the average daily alcohol consumption was 5.4 drinks.

When the researchers looked at those not on ART, they found that the adjusted mean CD4-positive T-cells averaged 48.6 cells per microliter of blood lower for those with heavy alcohol use than for those who were abstinent.

Heavy alcohol use is known to lessen adherence to therapy, which in turn increases the risk of HIV progression, the researchers noted.

But among study participants on ART, when the researchers controlled for adherence to therapy, there was no association between drinking and either disease progression marker.

One explanation for that might be that the large beneficial effect of the therapy outweighs the small negative effect of the alcohol, the research notes.

The study was unable to say much about moderate drinking, because only 10 per cent of participants reported that level of alcohol consumption.

That's not surprising, given that the study included people with alcohol problems: "Individuals with current or past alcohol dependence are likely to abstain or drink heavily," the researchers noted.

The findings of the research will be of particular importance in Kenya where heavy drinking is already associated with the emergence of hitherto uncommon diseases in the country. In the last finical year, East African Breweries Limited sold 3.2million hectoliters of beer.

National Aids Control Council (NACC) statistics show that Nairobi has the highest number of HIV positive people at 197,000 followed by Nyanza with 183,000. North Eastern province accounts for the lowest number at an impressive 9,000 people.