Depression and Alcohol Misuse Lower Odds of Achieving Viral Suppression in HIV

Man leaning on desk with alcohol and laptop
Man leaning on desk with alcohol and laptop
Symptoms of depression and heavy alcohol use interact to lower the chances of achieving virologic suppression in people with HIV infection.

Symptoms of depression and heavy alcohol use interact to lower the chances of achieving virologic suppression in people with HIV; therefore, interventions that target both depression and alcohol misuse may benefit those who are at high risk for poor outcomes, according to a study published in AIDS and Behavior.

Although people living with HIV (PLWHIV) who consistently adhere to antiretroviral therapy and have achieved sustained virologic suppression can have an comparatively normal lifespan,2,3 a substantial percentage of PLWHIV are not retained in care and fail to achieve or maintain virologic suppression.4-7 Depression and misuse of substances such as alcohol are highly prevalent in PLWHIV and are associated with decreased adherence to therapy and retention in HIV care.8-16 

Because depression and alcohol abuse are modifiable risk factors for poor HIV outcomes, researchers examined how they interact to affect HIV control in 14,380 PLWHIV from 8 clinical sites across the United States.1 They found that among PLWHIV with no or mild depression, heavy alcohol use had no association with virologic suppression; however, reduced viral suppression was noted among PLWHIV who had moderate or severe depression symptoms. These data indicate that the interaction between symptoms of depression and heavy alcohol use were present only in PLWHIV who were not taking antidepressants.

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“These results underscore the importance of recognizing and treating depression in [PLWHIV], particularly among persons with heavy alcohol use, and suggest that deploying integrated, multifaceted interventions that target both depression and alcohol misuse could greatly benefit a subset of PLWHIV at high risk for poor outcomes,” concluded the study authors.1


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This article originally appeared on Infectious Disease Advisor