07 Apr HIV/AIDS and Alcohol: Intertwining Stories
Although alcohol abuse is known primarily for its ability to damage the liver, people who drink excessive amounts of alcohol also significantly increase their risks for several serious lung ailments, including pneumonia and a condition called acute respiratory distress syndrome (ARDS). People infected with the human immunodeficiency virus (HIV) also have increased risks for a variety of serious lung ailments. Although no one is quite sure how the lung effects of alcohol abuse and HIV overlap, current evidence indicates that the combined presence of these two health problems may contribute to a significant increase in lung damage.
Effects of Alcohol Abuse
People who regularly abuse alcohol develop several changes in their normal body function that can contribute to an increase in significant lung infections, according to review of multiple studies conducted in 2010 by the National Institute on Alcohol Abuse and Alcoholism (NIAAA). These changes include a reduction in saliva output that encourages the excessive growth of mouth and throat bacteria, a reduced level of activity in the cellular hairs (called cilia) that help eject both mucus and foreign particles from the airways, and impairment of the immune functions inside the lungs that help these paired organs limit the effects of any infectious microorganisms that make their way to the lung tissues. As a result of these changes, alcohol abusers have increased risks for developing serious cases of bacterial pneumonia, as well as severe complications related to the presence of pneumonia.
Chronic alcohol abuse is also a major factor in the development of ARDS. People with this condition develop inflammation, fluid accumulation, and eventual collapse in tiny sacs called alveoli that the body relies on to exchange oxygen from the lungs to the bloodstream, and to exchange carbon dioxide waste from the bloodstream to the lungs. The inability to effectively move oxygen from the lungs to the circulatory system leaves ARDS sufferers with a potentially fatal oxygen deficit inside their organs and tissues.
Effects of HIV
Inside the lungs, HIV produces damage in two distinct ways. First, the virus attacks, colonizes and gradually destroys white blood cells in the immune system called CD4 T-cells, which normally help alert other portions of the immune system to the presence of harmful microorganisms in the lungs’ tissues. HIV also attacks and kills immune cells in the lungs called alveolar macrophages, which respond to the call of CD4 T-cells by locating, surrounding, and eating bacteria and other foreign invaders. Without the numbers of CD4 T-cells and alveolar macrophages required to activate an effective immune response, the lungs become unusually susceptible to bacterial pneumonia and a range of other conditions that can seriously degrade an HIV-positive individual’s lung-related health.
Alcohol abuse and HIV infection create three underlying effects that can inhibit immune function and contribute to the onset of pneumonia and other serious lung ailments, the authors of the 2010 NIAAA review explain. First, each of these health problems reduces the ability of the immune system’s macrophages to hunt down and destroy bacteria and infectious microorganisms. Alcohol abuse and HIV infection also reduce normal lung levels of substances called antioxidants, which usually protect lung tissues from cell-damaging particles called free radicals, and thereby prevent a tissue-injuring process known as oxidative stress. In addition, both alcohol abuse and HIV infection can significantly lower the body’s supply of an essential mineral called zinc. This mineral is required to produce key protective antioxidants, and also helps cells throughout the body properly follow the internal instructions issued by cellular DNA. When a zinc deficiency occurs, one of its major effects is a degradation of effective immune system function.
Theoretically, the lung-related effects of alcohol abuse and HIV infection overlap and produce a combined level of risk that’s greater than the level of risk associated with alcohol abuse alone, or with HIV infection alone. However, the National Institute on Alcohol Abuse and Alcoholism reports that while these connections make logical sense, no one has directly studied them and turned theory into practical knowledge.
In addition to direct impacts on their lung health, HIV-positive alcohol abusers may experience indirect lung-related harm as a consequence of malnutrition or lack of regular compliance with antiretroviral therapy (ART), a state-of-the-art medication regime used to effectively limit HIV reproduction and protect the body from HIV-related health complications.
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