Lower Alcohol Tolerance Seen in Men with HIV

HIV-infected men may be more sensitive to alcohol’s effects.

Previous studies have demonstrated alcohol use even below standard drinking limits can lead to particularly harmful consequences for individuals with HIV. For example, drinking may cause nonadherence to antiretroviral therapy, liver fibrosis, and damage to the immune system. In addition, intoxication can lead to risky sexual behavior.

More recently, research published in AIDS and Behavior examined 2 groups of veterans—1478 men with HIV and 1170 without it—to determine the average number of drinks it takes to generate a buzz.

Of the HIV-infected men, 607 had detectable HIV-RNA viral load (VL), while 871 had suppressed VL. For those with detectable VL, the average number of alcoholic drinks to feel intoxicated was 2.8, compared with 2.9 for those with suppressed VL. This means men with detectable HIV infection had lower alcohol tolerance than men with suppressed infection.

Compared with the HIV-infected men, the uninfected men had higher alcohol tolerance, the researchers found. The percentage of men who reported 4 drinks led to a buzz was lower among men with HIV (24.1% for detectable VL, 28.3% for suppressed VL) than those without it (35.6%).

Overall, the researchers determined men with detectable HIV-RNA VL feel intoxicated from consuming just one-quarter less of a drink than uninfected men.

However, a model considering body mass index (BMI) found it can mediate the association between HIV status and the number of drinks it takes to feel a buzz. When the model was adjusted for BMI, the researchers found this greater sensitivity to alcohol was seen only in those with detectable VL.

The study authors suggested individuals with HIV should consider a lower threshold for alcohol consumption, and BMI should also be taken into account.

“Providers should consider these findings as they screen for alcohol use and counsel patients regarding the impact of alcohol on HIV infection,” the researchers concluded.

In the study, it was not clear whether the HIV-infected men were more susceptible to alcohol or saw greater alcohol concentration in their blood from the same number of drinks.