Alcohol consumption and neurocognitive deficits in people with well-treated HIV in Switzerland. PLoS ONE
Darling et al. examined the association between alcohol consumption and neurocognitive impairment (NCI) among participants of the Neurocognitive Assessment in the Metabolic and Aging Cohort (NAMACO) within the SHCS.
Participants had standardized neurocognitive testing performed. Individuals were categorized as having NCI when testing was abnormal in at least two of the five domains: motor skills, information processing, attention memory, executive function and verbal episodic memory. Alcohol consumption was assessed using the Alcohol Use Disorders Identification Test for Consumption (AUDIT-C), which includes information on frequency and quantity of alcohol consumption and the practice of binge drinking (>6 drinks on one occasion). Associations between alcohol consumption and neurocognitive impairment were analyzed using multivariable logistic regression, adjusted for age, sex, origin, education level and drug use.
The study included 981 patients with a mean age of 54.5 years, 79.7% were men, 91.7% were Caucasian, and 96.2% had a suppressed HIV viral load at the time of neurocognitive testing. Authors found a U-shaped relationship between AUDIT-C scores and the probability of NCI: The probability of NCI decreased slightly between an AUDIT-C between 0 and 4, and started to increase thereafter (p = 0.03). The strongest associations were present between binge drinking and abnormalities in motor skills (OR 2.42, p = 0.01) and speed of information processing (OR 2.15, p = 0.02).
In summary, the study found a U-shape association between alcohol consumption and the development of NCI, with the practice of binge drinking being the most important predictor. These findings underline the importance of tailored risk reduction counselling for people living with HIV. Longitudinal data analyses within NAMACO will help to further understand and characterize the impact of alcohol consumption on the development of NCI.