Heavy Alcohol Use & Oxidative Stress as Measured by 8-Isoprostane Among People Living With HIV

Introduction: Alcohol intake contributes to the pathogenesis of alcohol-related liver disease in part through the propagation of reactive oxygen species. Eight-isoprostane, a stable by-product of lipid-peroxides, is a measure of in vivo oxidative stress. Several markers of oxidative stress are elevated in people with HIV (PWH) who consume alcohol compared to their HIV-negative counterparts who also drink. However, the link between the amount of alcohol consumption and oxidative stress remains largely unknown in this population. Methods: Between 2017-2019, the Studying Partial-agonists for Ethanol and Tobacco Elimination in Russians with HIV (St PETER HIV) study collected data from 400 PWH aged 18-70 years in St. Petersburg, Russia who endorsed ≥5 heavy drinking days in the past 30 days. Participants were invited to engage in 5 in-person assessments and blood draw visits over 12 months. Linear mixed effect models were used to estimate the association between total grams of alcohol consumed within 30 days and 8-isoprostane levels at baseline and 3 months. Secondary analyses were conducted with phosphatidyl ethanol (PEth) dichotomized as positive or negative. Each analysis was adjusted for age, sex, body mass index (BMI), CD4 count, log transformed HIV viral load, diabetes, smoking, illicit drug use, history of hepatitis C infection, FIB-4, and renal dysfunction. Results: The final sample included 399 individuals, among whom the mean total grams of alcohol consumed within 30 days was 1019.0g ± 830.0g (mean ± standard deviation) and 68% had a positive PEth (124 ng/ml ± 250 ng/ml). The mean 8-isoprostane concentration (pg/ml) was 26 pg/ml ± 15.0 pg/ml. The primary adjusted analysis showed that a 1kg increase in total grams of alcohol was associated with a 5% increase in 8-isoprostane levels; however, the association was of borderline statistical significance (Ratio of means 1.05; confidence limits (CL) 1.00, 1.10; P=0.057). Secondary analyses found positive PEth was associated with higher 8-isoprostane levels (Ratio of means 1.13; 95% CL 1.04, 1.22; P=0.003). Conclusion: Among this sample of PWH, we did not observe a clear relationship between self-reported total grams of alcohol consumed within the last 30 days and oxidative stress. Testing positive for PEth however was associated with a measure of oxirectly correlated with 8-isoprostane levels and whether reducing or eliminating alcohol use correlates with lower oxidative stress.