Association between alcohol use and inflammatory biomarkers over time among younger adults with HIV—The Russia ARCH Observational Study
Summary and context
Researchers from Boston University School of Medicine (BUSM) analyzed biological markers of innate immune function, a kind of immune response that acts quickly and non-specifically to new infections and pathogens. They investigated biological markers of three specific immune processes:
- systemic inflammation,
- monocyte activation, and
- altered coagulation.
Higher levels of biological markers for these processes have previously been associated with higher risk of death. In the current study, the researchers assessed self-reported alcohol use over time (three times over two years) and also measured alcohol use using a blood-based marker of alcohol consumption called PEth (phosphatidylethanol) that detects alcohol consumption up to about 21 days after alcohol intake. Additionally they measured other behaviors and health conditions that could obscure the true relationship between alcohol consumption and these biomarkers.
We found that people who reported [consuming] more alcohol or had high PEth had higher levels of these biomarkers of immune function,” said corresponding author Kaku So-Armah, PhD, assistant professor of medicine at BUSM, as per Science Digest.
The fact that heavy alcohol consumption was linked to elevated levels of these biomarkers, which are linked to mortality, suggests that alcohol may be contributing to mortality risk through immune dysfunction among people with HIV.”Kaku So-Armah, PhD, assistant professor of medicine, Boston University School of Medicine
According to the researchers, it is important to note they observed elevated levels of these biomarkers of immune activity in a relatively young HIV population with a low occurrence of chronic inflammatory diseases of aging like diabetes, obesity or renal disease.
Further we observed that the relationship between alcohol consumption and some of these biomarkers was not linear, suggesting a complex relationship between alcohol use and biomarkers of systemic inflammation and monocyte activation,” via Science Digest.Kaku So-Armah, PhD, assistant professor of medicine, Boston University School of Medicine
While the researchers stress that this is an observational study and the findings do not prove causality, they hope the study highlights the harms associated with heavy alcohol consumption among people living with HIV.
Biomarkers of monocyte activation (soluble CD14 [sCD14]), inflammation (interleukin-6 [IL-6]), and altered coagulation (D-dimer) are associated with increased mortality risk in people with HIV. The objective of the Russia Alcohol Research Collaboration on HIV/AIDS (ARCH) study was to evaluate the association between heavy alcohol use and inflammatory biomarkers over time.
The study sought antiretroviral therapy naive participants with HIV and assessed them at baseline, 12 and 24 months. Linear mixed effects models were used to determine whether heavy alcohol use (self-report augmented by phosphatidylethanol [PEth], an alcohol biomarker) was longitudinally associated with IL-6, sCD14 and D-dimer adjusting for potential confounders (e.g., demographics, HIV factors, comorbid conditions).
Participants’ baseline characteristics were as follows:
- 71% male;
- mean age of 34 years;
- 87% self-reported hepatitis C; and
- 86% current smokers.
- Mean log10 (HIV RNA) was 4.3 copies/mL.
Heavy alcohol use, based on National Institute of Alcohol Abuse and Alcoholism risky alcohol consumption criteria and PEth (versus non-heavy alcohol use) was associated with higher sCD14, IL-6, and D-dimer across the two-year follow-up.
Among HIV+ adults, current heavy alcohol use is associated with higher sCD14, IL-6 and D-dimer over time. Since these biomarkers are associated with mortality, interventions to mitigate effects of heavy alcohol use on these immune processes merit consideration.