Abstract
BackgroundDespite the excessive rates of Hazardous Alcohol Use (HAU) among people living with HIV (PLWH), although largely speculated, psychological and physiological components associated with HAU, has not been actively measured. Therefore, the present study was geared toward determining: 1) the rates of mood disorders and its relationship with HAU, and 2) to assess the impact of Brain Derived Neurotrophic Factor (BDNF), a well-known regulator of alcohol and mood disorders.MethodsFor this study, participants of the longitudinal PADS Study n=400, were followed over time. Alcohol use (Alcohol Use Disorders Identification Test –AUDIT- and the Alcohol Dependence Scale –ADS) and moods (depression, anxiety, and stress) were assessed repeatedly.ResultsA cluster analyses shows three distinctive trajectories. The first one, revealed a group with increased drinking (Cluster 1: n=140), constant alcohol intake (Cluster 2: n = 60), and one with decreased consumption (Cluster 3: n =120).Analyses discovered higher AUDIT scores across the clusters with Cluster 1 being followed by Clusters 2 and 3 (1: 14.5 ± 8 vs. 2=8.7 ± 7.5 vs. 3= 6.6 ± 4.2, p = 0.001). Women in Clusters 1 and 2 had higher levels of stress (1:21 ± 7.5; 2:19.3 ± 7) and lower BDNF levels (7904 ± 1248 pg/ml and 10405 ± 909 pg/mL) than their counterparts in Cluster 3 (PSS: 3: 16.6 ±5, p = 0.02 BDNF: 10828 ± 1127 pg/mL, p = 0.08). Men in Cluster 1 differed in terms of stress (19.8 ± 7 vs. 21 ± 7.5 score) and BDNF levels (Cluster 1: 5204 ± 818 vs. Cluster 2: 7656 ± 843 pg/ml, p = 0.002) but not in the number of years living with HIV. The proportion of subjects with multiple mood comorbidities was disturbingly higher (26%), and all were members of Cluster 1. Multiple logistic regression analyses indicated that participants reporting high relative to low levels of perceived stress, dual mood comorbidity, altered BDNF levels and low income increased the likelihood of being a member of Cluster 1.ConclusionThis study found that stress and overlaying psychiatric comorbidities are linked with persistent alcohol use. Findings suggest that BDNF and social support seems to be a logical target as it seems to be the bridge linking mood disorders and alcohol consumption.
Highlights
While in the beginning of the HIV epidemic concerns were primarily related to drug addiction
This study found that stress and overlaying psychiatric comorbidities are linked with persistent alcohol use
Findings suggest that Brain Derived Neurotrophic Factor (BDNF) and social support seems to be a logical target as it seems to be the bridge linking mood disorders and alcohol consumption
Summary
While in the beginning of the HIV epidemic concerns were primarily related to drug addiction. HAU is a topic of theoretical interest for both, researchers and health care providers, given its excessive rates (40-80%) [2,3,4,5,6], little information is available with regards to the underpinnings mediating the excessive rates among PLWH. BDNF heterozygous mice, which expressed about half as much BDNF protein as their wild-type counterparts, displayed increased conditioned place preferences and locomotor sensitization to alcohol [10,11,12,13]. They showed prolonged alcohol consumption, following a period of abstinence, suggesting that BDNF may decrease the rewarding effects of alcohol [13]. The present study was geared toward determining: 1) the rates of mood disorders and its relationship with HAU, and 2) to assess the impact of Brain Derived Neurotrophic Factor (BDNF), a well-known regulator of alcohol and mood disorders
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