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Lower Blood Alcohol Concentration Among HIV‐Positive Versus HIV‐Negative Individuals Following Controlled Alcohol Administration
Author(s) -
Shuper Paul A.,
Joharchi Narges,
Rehm Jürgen
Publication year - 2018
Publication title -
alcoholism: clinical and experimental research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.267
H-Index - 153
eISSN - 1530-0277
pISSN - 0145-6008
DOI - 10.1111/acer.13816
Subject(s) - medicine , alcohol , human immunodeficiency virus (hiv) , viral load , alcohol use disorders identification test , blood alcohol , alcohol consumption , demography , immunology , poison control , environmental health , injury prevention , biology , biochemistry , sociology
Background Although it has been purported that HIV ‐positive individuals may experience a greater degree of intoxication than HIV ‐negative individuals following acute alcohol consumption, no research to date has empirically tested this supposition. The present investigation entailed a randomized controlled experiment to identify whether the administration of a weight‐specified dose of alcohol would lead to differential blood alcohol concentrations ( BAC s) among HIV ‐positive versus HIV ‐negative men. Methods In a specialized barroom laboratory, 143 men ( n = 76 HIV ‐positive and n = 67 HIV ‐negative; mean age = 42.9) consumed beverages based on a formulation of 0.7 g alcohol/kg body weight over a 15‐minute time frame. BAC was assessed via breathalyzer at 2 set time points (10 and 13 minutes postconsumption) and then periodically until detoxification ( BAC < 0.040%). Primary outcomes included (i) area under the curve ( AUC ), calculated based on all of one's BAC readings, (ii) “ BAC ‐ EXP ,” defined as one's BAC reading 13 minutes postconsumption, and (iii) BAC ‐ PEAK , defined as one's highest recorded BAC reading. Results Contrary to predictions, AUC ( t (141) = 2.23, p = 0.027), BAC ‐ EXP ( t (141) = 2.68, p = 0.008), and BAC ‐ PEAK ( t (141) = 2.29, p = 0.023) were significantly lower among HIV ‐positive versus HIV ‐negative participants. These effects were sustained in multivariable models controlling for age, race, and AUDIT ‐based hazardous drinking classification. Among the HIV ‐positive sample, outcomes did not significantly differ based on HIV viral load detectability, antiretroviral therapy ( ART ) status, or ART adherence. Conclusions The administration of a controlled, weight‐specified dose of alcohol led to lower BAC s among HIV ‐positive versus HIV ‐negative participants. These differences might derive from decreased body fat percentage and delayed gastric emptying associated with HIV seropositivity; however, additional research is necessary to verify these mechanisms. Unique alcohol dosing formulas based on HIV serostatus may be required in future alcohol administration experiments involving HIV ‐positive samples.