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Moderate alcohol consumption may be more harmful to people with HIV
Keith Alcorn, 2016-02-10 10:00:00

Safe drinking limits for people living with HIV may be lower than the recommendations for the rest of the population, a large US cohort study suggests, especially in people not taking antiretroviral therapy. The findings are published by the journal Drug and Alcohol Dependence.

The study findings indicate that only one country – the United Kingdom – is currently recommending a level of alcohol consumption for the general population that would also minimise the harm of alcohol consumption for people living with HIV. All other national drinking limits for safer consumption would still place people with HIV at increased risk of alcohol-related harm compared with counterparts without HIV, the study shows. The study found that drinking more than 14 units a week – about one drink a day in US terms – increased the risk of death for men with HIV. The increased risk of death only became evident for men without HIV at higher levels of alcohol consumption.

Safe drinking advice now varies widely from country to country. Recently issued United Kingdom guidance recommends no more than 14 units a week for men and women, compared to the equivalent of 24 units a week for men in the United States (14 drinks per week) and 35 units a week in Spain. US guidance recommends women to restrict alcohol intake to 12 units a week, whereas Spanish guidance recommends no more than 21 units a week for women.

High alcohol consumption raises the risk of developing a wide range of cancers, particularly breast cancer in women, and bowel cancer, oesophageal cancer and cancers of the mouth and throat in both sexes.

The risk of cancers in the mouth, throat and oesophagus (gullet) is further raised by smoking in people who drink alcohol. Alcohol also increases the absolute risk of liver cancer.

High alcohol consumption also increases the risk of stroke and cardiovascular disease, in particular by raising blood pressure. There is considerable debate as to whether drinking a small amount of alcohol protects against heart disease.

United Kingdom drinking advice has been calculated so that for a person who drinks 14 units or less each week, the risk of dying of an alcohol-related condition is one in a hundred. In a briefing for journalists issued by the Science Media Centre last month, Professor Matt Field of Liverpool University’s UK Centre for Tobacco and Alcohol Studies set out the absolute risk of some cancers at higher levels of alcohol consumption: “Among men, approximately 8 in 1000 non-drinkers or drinkers who stick to the weekly limit (no more than 14 units per week) are at risk of developing liver cancer, but this rate rises to 11 in 1000 for men who drink between 14 and 35 units per week. But for cancer of the oesophagus, the rates are increased for men who drink even within the weekly guideline (13 in 1000) compared to those who abstain completely (6 in 1000), and further increased for those who exceed the guideline (25 per 1000 in men who drink between 14 and 35 units per week).”