No evidence for a role of alcohol or other psychoactive drugs in accelerating immunodeficiency in HIV-1-positive individuals. A report from the Multicenter AIDS Cohort Study
R. A. Kaslow, W. C. Blackwelder, D. G. Ostrow, D. Yerg, J. Palenicek, A. H. Coulson and R. O. Valdiserri
National Institute of Allergy and Infectious Diseases, Bethesda, MD 20892.
In a multicenter cohort study of homosexual men, the proportion of
seropositives at enrollment who developed the acquired immunodeficiency
syndrome (AIDS) during the following 18 months ranged from 5.5% to 8.2% in
1597 alcohol drinkers vs 9.2% in 109 nondrinkers with no clear trend
according to use, and from 6.3% to 9.6% for 1662 users vs 7.2% for 83
nonusers of psychoactive drugs prior to enrollment. Among seropositive men
with low initial T helper lymphocyte counts, those who continued to use
drugs showed no significantly higher 18-month risk of AIDS than nonusers
(13% vs 10%); the corresponding risks were 13% and 15%, respectively, for
continued heavier vs continued lighter consumption of alcohol. No other
manifestations of immunodeficiency were positively associated with
substance use prior to enrollment. Prior use was not associated with low
mean T helper cell counts at enrollment, and continued drug or alcohol use
after enrollment was not associated with greater subsequent decline in
counts. As used in a large cohort of homosexual men, psychoactive
substances did not enhance the progression of human immunodeficiency virus
infection.
