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Alcohol abuse history could pose problems for HIV patients

COLUMBUS, Ohio Patients with HIV infection and a history of alcohol abuse may be at higher risk for cognitive problems than HIV-positive patients with no alcohol abuse history, an Ohio State University Medical Center study suggests.

As a result, the researchers advise health-care providers to counsel HIV-positive patients and those at highest risk for HIV infection about the possible neuropsychological effects of alcohol dependence.

People in the study who had previous alcohol abuse but were HIV-negative showed no significant loss of cognitive function. That suggests that a history of alcohol abuse either adds to the problems HIV infection can cause or has an interactive association with the infection's effects on the brain, said Dr. Robert Bornstein, senior author of the study published in the February issue of The American Journal of Psychiatry. Bornstein is a professor of psychiatry, psychology and neurology in Ohio State's College of Medicine and Public Health.

"This study suggests that previous alcohol abuse may create a point of vulnerability that is exacerbated by the effects of the virus on the brain. In contrast, in the absence of HIV infection, a past history of chronic alcohol abuse, combined with current abstinence from alcohol, appears to cause no significant cognitive impairment," Bornstein said. "There appears to be just enough alteration to cognitive function to make the brain more susceptible to the damaging impact of a second, independent process."

The known risk of cognitive decline in HIV infection has prompted attempts to identify risk factors for this decline, Bornstein said. Numerous studies have shown that deficits in memory and learning, slower reaction time and decreased speed in decision-making are commonly reported in HIV-positive patients. The most severe cognitive changes, sometimes to the point of dementia, are almost always reported in the latest stages of the illness, but some research has demo
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Contact: Emily Caldwell
caldwell.151@osu.edu
614-293-3737
Ohio State University
10-Feb-2004


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