Focus on the Heart: Alcohol Consumption, HIV Infection, and Cardiovascular Disease

By Freiberg, Matthew S.; Kraemer, Kevin L. | Alcohol Research, July 1, 2010 | Go to article overview

Focus on the Heart: Alcohol Consumption, HIV Infection, and Cardiovascular Disease


Freiberg, Matthew S., Kraemer, Kevin L., Alcohol Research


With the advent of effective antiretroviral therapy, people infected with HIV have a longer life expectancy and, consequently, are likely to develop other chronic conditions also found in noninfected people, including cardiovascular disease (CVD). Alcohol consumption, which is common among HIV-infected people, may influence the risk of CVD. In noninfected adults, moderate alcohol consumption can reduce the risk of coronary heart disease (CHD), heart attacks, and the most common type of stroke, whereas heavy drinking increases the risk of these cardiovascular events. These relationships can be partially explained by alcohol's effects on various risk factors for CVD, including cholesterol and other lipid levels, diabetes, or blood pressure. In HIV-infected people, both the infection itself and its treatment using combination antiretroviral therapy may contribute to an increased risk of CVD by altering blood lipid levels, inducing inflammation, and impacting blood-clotting processes, all of which can enhance CVD risk. Coinfection with the hepatitis C virus also may exacerbate CVD risk. Excessive alcohol use can further enhance CVD risk in HIV-infected people through either of the mechanisms described above. In addition, excessive alcohol use (as well as HIV infection) promote microbial translocation-the leaking of bacteria or bacterial products from the intestine into the blood stream, where they can induce inflammatory and immune reactions that damage the cardiovascular system. KEY WORDS: Alcohol consumption; alcohol use disorder; heavy drinking; alcohol and other drug effects and consequences; human immunodeficiency virus; antiretroviral therapy; combination antiretroviral therapy; cardiovascular disease; coronary heart disease; stroke

Currently, more than 60 different medical conditions and 4 percent of the global health burden of disease are caused at least in part by, or are attributable to, alcohol consumption (Room et al. 2005). In the United States, 62.5 percent of adults consume alcohol and 17.6 million have an alcohol use disorder (AUD) (Centers for Disease Control and Prevention 2003; Grant et al. 2004). Because of this widespread and, in many cases, excessive alcohol use, alcohol consumption is associated with the two leading causes of death in the United States-cardiovascular disease (CVD)1 and cancer (Mokdad et al. 2005).

Alcohol consumption and AUDs also are common among adults infected with the human immunodeficiency virus (HIV) (Conigliaro et al. 2003; Cook et al. 2001). With the advent of antiretroviral therapy and, as a result, an increasing life expectancy in this population (Palella et al. 1998), chronic diseases such as coronary heart disease (CHD) have become a prevalent and important health issue facing adults with HIV(FriisMoller et al. 2003b; Holmberg et al. 2002, 2004; Klein et al. 2002). For example, among HIVinfected participants in the Veterans Aging Cohort Study (VACS), hazardous drinking and AUDs were independently associated with an increased prevalence of CVD, even after adjusting for traditional CVD risk factors, such as cholesterol levels or coexisting diabetes (Freiberg et al. 2010). Furthermore, among HIVinfected people with an AUD, those who were coinfected with the hepatitis C virus (HCV) had an even higher prevalence of CVD (Freiberg et al. 2007). However, the mechanism(s) by which alcohol use and HCV infection may influence cardiovascular risk and other chronic diseases among HIVinfected people remain unknown.

This article explores the relationships between alcohol use, HIV infection, and CVD. After reviewing the association between alcohol use and CVD among HIVuninfected adults and the relationship between HIV infection and CVD, the article examines the role of alcohol consumption in CVD among HIVinfected adults. It concludes with a discussion of possible mechanisms underlying alcohol's association with CVD among HIVinfected adults.

ALCOHOL USE AND CVD AMONG HIV-UNINFECTED ADULTS

CVD refers to any type of disease involving the heart or blood vessels. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Focus on the Heart: Alcohol Consumption, HIV Infection, and Cardiovascular Disease
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Author Advanced search

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.