Abstract
The body of knowledge on alcohol use and communicable diseases has been growing in recent years. Using a narrative review approach, this paper discusses alcohol’s role in the acquisition of and treatment outcomes from four different communicable diseases: these include three conditions included in comparative risk assessments to date—Human Immunodeficiency Virus (HIV)/AIDS, tuberculosis (TB), and lower respiratory infections/pneumonia—as well as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) because of its recent and rapid ascension as a global health concern. Alcohol-attributable TB, HIV, and pneumonia combined were responsible for approximately 360,000 deaths and 13 million disability-adjusted life years lost (DALYs) in 2016, with alcohol-attributable TB deaths and DALYs predominating. There is strong evidence that alcohol is associated with increased incidence of and poorer treatment outcomes from HIV, TB, and pneumonia, via both behavioral and biological mechanisms. Preliminary studies suggest that heavy drinkers and those with alcohol use disorders are at increased risk of COVID-19 infection and severe illness. Aside from HIV research, limited research exists that can guide interventions for addressing alcohol-attributable TB and pneumonia or COVID-19. Implementation of effective individual-level interventions and alcohol control policies as a means of reducing the burden of communicable diseases is recommended.
Highlights
Alcohol consumption was recognized as a risk factor for infectious lung diseases, such as pneumonia, as early as 1785, in Benjamin Rush’s seminal work on the effects of spirits on the human body and mind [1]
This oversight is all the more astonishing as the association is readily apparent in research and practice, for instance, by the high prevalence of people with alcohol use disorders (AUDs) in tuberculosis treatment [6]; or by the strong associations between alcohol use and Human Immunodeficiency Virus (HIV)/AIDS in surveys or other empirical studies [7,8,9,10,11,12]
Alcohol use can facilitate HIV acquisition/transmission by (1) decreasing host immune efficiencies among those living without HIV and (2) increasing viral replication among people living with HIV
Summary
Alcohol consumption was recognized as a risk factor for infectious lung diseases, such as pneumonia, as early as 1785, in Benjamin Rush’s seminal work on the effects of spirits on the human body and mind [1]. We can only speculate as to why the strong association between alcohol use and infectious disease was overlooked in global risk assessments for such a long time This oversight is all the more astonishing as the association is readily apparent in research and practice, for instance, by the high prevalence of people with alcohol use disorders (AUDs) in tuberculosis treatment [6]; or by the strong associations between alcohol use and HIV/AIDS in surveys or other empirical studies [7,8,9,10,11,12]. Alcohol has been identified as a driver of this epidemic, facilitating HIV acquisition/transmission and disease progression through both behavioral and biological means
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