ALCOHOL AND AIDS

Alcohol and AIDS (acquired immunodeficiency syndrome) from infection with HIV (human immunodeficiency virus) are each separately agents that cause suppression of immune function. Therefore regular use of alcohol by people infected with HIV should be more suppressive than either alone. Some of the most interesting questions about infection with HIV including the following: Why does progression to AIDS after HIV infection vary in length of time from under 1 year to 15 years of more? Does inhibition of mental functions by heavy alcohol use increase risky sexual behaviors and thus the chance of becoming infected with HIV? Does alcohol use or abuse affect the production of the virus or the invasion of cells by the virus?

Conventional wisdom based on long experience is that alcohol's relaxation of sexual inhibition will increase risky sexual behaviors in those who use alcohol even in moderation (2-3 drinks a day). Risky behaviors include unprotected vaginal or anal intercourse with more than one partner, unprotected intercourse with intravenous drug users, who have a high risk of HIV infection, and unprotected oral sex with potentially protected infected partners. Anyone who has used intravenous drugs or had sex with more than one person is at significant risk of infection with HIV and other pathogens.

Cocaine and other drugs of abuse are commonly used along with alcoholic beverages. They appear to synergize in terms of affecting behavior, thereby enhancing the risk of HIV infection should one be exposed. In addition, studies in the laboratory have shown that alcohol use increases the susceptibility of cells to HIV, increasing the likelihood that an invading HIV virus will successfully cause disease. Animal studies involving mice with AIDS show that alcohol and cocaine clearly suppress immune function, more than AIDS alone. During alcohol and cocaine use, mice infected with the virus that causes AIDS are much more susceptible to cancer and pathogens, and die sooner.

While epidemiological studies in humans have been inconclusive, animal models and test tube studies with human cells clearly demonstrate that alcohol increases the immune damage resulting from retrovirus infection. Alcohol may lower resistance to disease and tumors in AIDS patients, may accelerate development of AIDS by those who are HIV infected, may increase HIV production by cells, and may increase cellular susceptibility to HIV infection.

AIDS patients suffer from various opportunistic pathogens, which normally do not grow sufficiently to cause disease in immunologically normal people. Alcohol and cocaine exacerbate the immune dysfunction in studies with mice. They also increase the extent of colonization in mice with AIDS by two opportunistic parasites, Giardia and Cryptosporidium. Normal mice and humans are not as are essentially resistant to such parasites. Alcohol is a cofactor that accentuates immune damage resulting from the HIV retrovirus.

BIBLIOGRAPHY

Watson R. R. & Gottesfeld, Z. Neuroimmune effects of alcohol and its role in AIDS. Advances In Neuroimmunology 3 (1993): 151-162.

Watson, R.R. et al. Alcohol, immunomodulation, and disease. Alcohol and Alcoholism 29 (1996): 131-139.

Watson, R. R., ed. Nutrition and AIDS II. CRC Press in Press, 2000.

Ronald Ross Watson