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Heavy alcohol consumption in individuals with HIV infection: Effects on neuropsychological performance

Published online by Cambridge University Press:  28 January 2005

JOHANNES C. ROTHLIND
Affiliation:
Mental Health Service, DVA Veterans Affairs Medical Center, San Francisco Department of Psychiatry, University of California, San Francisco
TANYA M. GREENFIELD
Affiliation:
Magnetic Resonance Unit, DVA Veterans Affairs Medical Center, San Francisco Department of Radiology, University of California, San Francisco
ANNE V. BRUCE
Affiliation:
Magnetic Resonance Unit, DVA Veterans Affairs Medical Center, San Francisco
DIETER J. MEYERHOFF
Affiliation:
Magnetic Resonance Unit, DVA Veterans Affairs Medical Center, San Francisco Department of Radiology, University of California, San Francisco
DEREK L. FLENNIKEN
Affiliation:
Magnetic Resonance Unit, DVA Veterans Affairs Medical Center, San Francisco
JOSELYN A. LINDGREN
Affiliation:
Magnetic Resonance Unit, DVA Veterans Affairs Medical Center, San Francisco
MICHAEL W. WEINER
Affiliation:
Magnetic Resonance Unit, DVA Veterans Affairs Medical Center, San Francisco Department of Psychiatry, University of California, San Francisco Department of Radiology, University of California, San Francisco Department of Medicine, University of California, San Francisco Department of Neurology, University of California, San Francisco

Abstract

Higher rates of alcohol use have been reported in HIV+ individuals compared to the general population. Both heavy alcohol use and HIV infection are associated with increased risk of neuropsychological (NP) impairment. We examined effects of heavy active alcohol use and HIV on NP functioning in a large sample of community-residing HIV+ individuals and HIV− controls. The four main study groups included 72 HIV− light/non-drinkers, 70 HIV− heavy drinkers (>100 drinks per month), 70 HIV+ light/non-drinkers, and 56 HIV+ heavy drinkers. The heavy drinking group was further subdivided to assess effects of the heaviest levels of active alcohol use (>6 drinks per day) on NP functioning. A comprehensive NP battery was administered. Multivariate analysis of covariance was employed to examine the effect of HIV and alcohol on NP functioning after adjusting for group differences in age and estimated premorbid verbal intellectual functioning. The analyses identified main effects of heavy drinking and HIV on NP function, with greatest effects involving the contrast of HIV+ heavy drinkers and the HIV− light drinkers. Synergistic effects of heaviest current drinking and HIV infection were identified in analyses of motor and visuomotor speed. Supplementary analyses also revealed better NP function in the HIV+ group with antiretroviral treatment (ART) and lower level of viral burden, a finding that was consistent across levels of alcohol consumption. Finally, heavy alcohol use and executive functioning difficulties were associated with lower levels of self-reported medication adherence in the HIV+ group. The findings suggest that active heavy alcohol use and HIV infection have additive adverse effects on NP function, that they may show synergistic effects in circumstances of very heavy active alcohol use, and that heavy drinking and executive functioning may mediate health-related behaviors in HIV disease. (JINS, 2005, 11, 70–83.)

Type
Research Article
Copyright
© 2005 The International Neuropsychological Society

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