Alcohol, Ethnicity, And HIV Treatment

AlcoholAlcohol, race, and ethnicity all play complicated roles in lipid-profile changes in patients taking highly active antiretroviral therapy (HAART), according to researchers from Florida International University in Miami. HAART is already known to cause dyslipidemia in 40% to 80% of patients.

A longitudinal study of 88 “hazardous” and 76 “nonhazardous” drinkers reveals some differences that underscore the importance of tailoring treatment.

At a baseline evaluation, Caucasian and Hispanic patients had the most adverse lipid profiles, whereas African American patients had the fewest atherogenic factors. Cholesterol levels increased more in the Caucasian patients (by 11%) and in Hispanic patients (by 6%), as did triglycerides (by 40% in Caucasians and by 24% in Hispanic patients). The rise in LDL was highest in the Hispanic hazardous drinkers and at least double that of any other group.
After the researchers adjusted for age, CD4 cell count, and dietary intake, Hispanic patients who were drinkers and who were receiving HAART had a doubled risk of hypertriglyceridemia; Caucasian drinkers had 1.5 times the risk. Heavy drinkers (having more than 30 drinks per week) had the highest risk.

The authors concluded that race and alcohol drags were independent risk factors for lipoprotein disturbances in HIV-infected patients, and they urged caution when prescribing HAART regimens containing protease inhibitors for certain Hispanic and Caucasian hazardous alcohol users.

The Urban Ministry defines hazardous drinking as consuming 21 or more drinks per week for men and 14 or more drinks per week for women (amounts that place individuals at risk for adverse health effects). The World Health Organization and the American Medical Association define hazardous drinking as any alcohol consumption that confers the risk of physical or psychological harm. “Harmful” drinking results in adverse events.

Sources: J Assoc Nurses AIDS Care 2009;20(3):176-183;