Alcohol abuse can complicate the health problems of HIV-infected veterans, making it crucial that providers recognize and treat alcoholism in that population, new studies conclude.
Veterans with HIV who binge drink or abuse alcohol in others ways often have higher viral loads and more severe symptoms of HIV disease and may have shorter life expectancies than those who don’t drink, say Joseph Conigliaro, M.D., M.P.H., of the VA Pittsburgh Health Care System and the University of Pittsburgh and colleagues.
“Because alcohol use and abuse are common among HIV-infected individuals, and because providers do not routinely identify alcohol use and abuse, providers should routinely screen and counsel HIV-infected patients regarding alcohol problems as part of a standard of care,” they write in the February issue of Alcoholism: Clinical and Experimental Research.
In one study, Conigliaro and others analyzed the effects of alcohol abuse in 881 HIV-infected veterans, using patient interviews and the VA hospital system’s detailed electronic medical records system. Thirty-six percent were diagnosed with either hazardous drinking or full-blown alcoholism.
HIV patients who abused alcohol were more likely to have aggravated HIV symptoms and co-occurring conditions like hepatitis C, the researchers found. In some cases, the biological interaction of alcohol and HIV produced the poor health outcomes. But alcohol’s behavioral effects also took a toll, particularly affecting patients’ adherence to complicated drug therapies and their access to health care.
Using a computer simulation, Scott Braithwaite, M.D., of the Center for Research on Health Care at the University of Pittsburgh and Amy Justice M.D., Ph.D., of the West Haven VA Healthcare System and Yale University School of Medicine calculated that poorer adherence to drug therapy among alcohol abusing veterans could subtract more than a year from their life expectancies.
Adam Gordon, M.D., M.P.H., also of the VA Pittsburgh Healthcare System and the University of Pittsburgh and Robert Cook, M.D., of the University of Pittsburgh found that homelessness, alcohol abuse and fewer visits to physicians also coincided in this group of veterans.
Despite the “mounting evidence that excessive alcohol use may be important in the management of HIV,” healthcare providers often missed the signs of alcohol abuse among their patients. Veterans in seemingly better health, without signs of liver disease or advanced HIV infection, were the most likely to be overlooked, according to the researchers.
“But these preliminary data suggest that HIV providers need to routinely screen and counsel patients for alcohol use as part of standard care,” Conigliaro says.
The studies were supported by the Robert Wood Johnson Foundation, National Institute of Alcoholism and Alcohol Abuse, Department of Veterans Affairs.
Articles in The Science of Mental Health are written by the originating institution. This article was originally posted to Newswise.
- Health Behavior News Service
