The bottom line: Alcohol

In the Futures 5 study, 77 percent of respondents said they had used alcohol in the previous 12 months. There is no evidence that moderate drinking (1-2 standard drinks per day) has any effect on HIV, and some studies in non-HIV- infected people have shown that an occasional tipple may be beneficial. But there is evidence that heavy drinking can have serious negative effects for people with HIV.

Heavy drinking can affect your immune system and there is some evidence from clinical trials that heavy drinkers have lower CD4 counts.

Alcohol can also affect the way that HIV drugs are processed in your liver [1]A large organ, located in the upper right abdomen, which assists in digestion by metabolising carbohydrates, fats and proteins, stores vitamins and minerals, produces amino acids, bile and cholesterol, and removes toxins from the blood., potentially increasing side effects or decreasing the levels of the drug in your bloodstream. Increases in blood fats [2]A type of fat in the blood. Elevated triglyceride levels may be a side effect of some anti-HIV drugs. (cholesterol [3]An essential component of cell membranes and nerve fibre insulation, cholesterol is important for the metabolism and transport of fatty acids and the production of hormones and Vitamin D. Cholesterol is manufactured by the liver, and is also present in certain foods. High blood cholesterol levels have been linked to heart disease and may be a side effect of some anti-HIV medications. and triglycerides), which have been linked to some HIV treatments, can be worse in heavy drinkers.

People who have hepatitis B or C as well as HIV should consider stopping drinking altogether or minimising their alcohol intake as both HIV and alcohol consumption are linked to more rapid hepatitis disease progression.

Long-term heavy alcohol consumption affects the liver, the heart and the brain and can lead to significant health problems, regardless of whether you’re HIV-positive or negative. People who drink every day are at risk of becoming dependent on alcohol, and may be more likely to develop mental health conditions.

THE BOTTOM LINE: For most people with HIV, moderate consumption of alcohol is probably harmless, but if you’re drinking more than 1-2 drinks a day or if you also have hepatitis B or C, it makes sense to consider reducing your alcohol intake.