Effect of chronic alcohol consumption on the red blood cell count and RBC indices in the HIV infected patients on d4T/3TC/NVP drug regimen in Uganda

Godfrey S. Bbosa, David B. Kyegombe, William W. Anokbonggo, Aloysius Lubega, Apollo Mugisha, Jasper Ogwal-Okeng


Alcohol consumption is common problem in Uganda. Among the types of alcohols consumed include beers, spirits, liqueurs, wines and traditional brew. These alcohols are easily accessible and consumed by many people including the HIV infected patients who are on the d4T/3TC/NVP regimen. The aim of this study was to determine the effect of chronic alcohol intake on the red blood cell count (RBC) and the RBC indices in the HIV-infected patients on d4T/3TC/NVP regimen. It was a case control study that used a repeated measures design model where serial measurements of the red blood cell count (RBC) and RBC indices were determined at 3 month interval for 9 months. A total of 41 HIV infected patients were recruited and grouped into two arms; the control group had 21 patients and the chronic alcohol group had 20 patients. The RBC and RBC indices of the whole blood were determined using automated hematological Coulter CBC-5 Hematology Analyzer system using standard procedures. The data was sorted into alcohol-use self reporting by WHO AUDIT tool and alcohol-use biomarkers groups. It was analysed using the SAS 2003 version 9.1 statistical package with the repeated measures fixed model. The means were compared using the student t-test. The mean MCV and MCH values in the chronic alcohol use group were higher than in the control group and there was a significant difference between the 2 groups (p<0.05) for both the WHO AUDIT tool group and chronic alcohol use biomarkers group. The mean RBC count, Hct, HGB and MCHC values in both the control and chronic alcohol use groups were within the normal reference ranges for both groups though the trend was lower in alcohol group. Chronic alcohol use affects the RBC and RBC indices in the HIV infected patients on d4T/3TC/NVP treatment regimen.


Chronic alcohol use, RBC, RBC indices, HIV infected patients, ARVs

Full Text:



Heath DB. Anthropology and alcohol studies: Current Issues. Annual Reviews Anthropology 1987;16:99-120.

Micheal, G., Alcohol health issues related to alcohol consumption. The place of alcohol in human culture., 1996: p. 1-22.

Wikipedia, Alcoholic beverage. Wikimedia Foundation Inc. USA. ''http://en.wikipedia.org/wiki/ Alcoholic_beverage''. 2009.

WHO, A Summary of Global Status report on Alcohol. Management of Sustance Dependence, Non-Communicable Diseases, World Health Organisation June 2001., 2001: p. 2-14.

WHO, Global Status Report on Alcohol 2004. 2004: Geneva, Switzerland.

WHO, Alcohol and Injury in Emergency Department: Summary of the Report from the WHO Collaborative Study on Alcohol and Injuries. WHO Library Cataloguing-in-Publication Data, 2007: p. 1-11.

Parry, C.D.H. and S. Dewing, A public Health Approach to Addressing Alcohol-related Crime in South Africa. African Journal of Drug and Alcohol Studies. CRISA Publications., 2006. 5(1): p. 41-53.

Kafuko, A. and P. Bukuluki, Qualitative research in Uganda on knowledge, attitude and practices concerning alcohol. 2008, USAID, Health Communication, YEAH and Afford: Corporate Agreement number 617-A-00-07-00005-00.

Lwanga-Ntale, C., Drinking into deeper poverty: The new frontier for Chronic Poverty in Uganda. Chronic Poverty Research Center: Development Research and Training. Policy Brief No.1/2007., 2007.

Obot, I.S., Alcohol use and related problems in Sub-saharan Africa. African Journal of Drug and Alcohol Studies. CRISA Publications., 2006. 5(1): p. 17-25.

YEAH, Alcohol Consumption in Uganda: Literature Review. (Young Empowered and Health -YEAH) http://www.yeahuganda.org/research/AlcoholConsumption.pdf (Accessed on 22/07/09). 2007.

Jernigan, D.H. and I.S. Obot, Thirsting for the African market. African Journal of Drug and Alcohol Studies. CRISA Publications., 2006. 5(1): p. 57-68.

Ovuga, E. and C. Madrama, Burden of alcohol use in the Uganda police in Kampala district. African Health Sciences, 2006. 6(14-20.).

Edenberg, H.J., The role of alcohol dehydrogenase and aldehyde dehydrogenase variants:The genetics of alcohol metabolism. The Journal of the National Institute on Alcohol Abuse and Alcoholism., 2007. 30(1): p. 5-12.

Eng, M.Y., S.E. Luczak, and T.L. Wall, ALDH2, ADH1B and ADH1C genotypes in Asians: A literature Review. The Journal of the National Institute on Alcohol Abuse and Alcoholism., 2007. 30(1): p. 22-26.

Quertemont, E. and V. Didone, Role of acetaldyde in mediating the Pharmacological and Behavioral effects of alcohol. The Journal of the National Institute on Alcohol Abuse and Alcoholism., 2006. 29(4): p. 258-264.

Scott, D.M. and R.E. Taylor, Health-related effects of genetic variations of alcohol-metabolising enzymes in African Americans. The Journal of the National Institute on Alcohol Abuse and Alcoholism., 2007. 30(1): p. 18-20.

Zakhari, S., Overview: How is alcohol metabolised by the body? The Journal of the National Institute on Alcohol Abuse and Alcoholism., 2006. 29(4): p. 245-252.

Edith, L., et al., Effect of alcohol consumption on blood antioxidant nutrients and oxidative stress indicators. American Journal of Clinical Nutrition., 1994. 60: p. 255-261.

Fleming, M., S.J. Mihic, and R.A. Harris, Ethanol. Goodman Gilman’s, the pharmacological basis of therapeutics. McGraw-Hill Medical publishing Division, New York. 10th ed. 2001(18): p. 429-442.

Haile, H.E., Booze and blood: The effect of acute and chronic alcohol abuse on the hematopoietic system. Clinical Laboratory Science, July-August 1998., 1998. 11(4): p. 229.

O’Neil, P., et al., Performance Evaluation of the Complete Blood Count and White Blood Cell Differential Parameters on the AcT 5diff Hematology Analyzer. Laboratory Hematology. Beckman Coulter, Inc, Diagnostics Division, Miami, Florida, USA. Carden Jennings Publishing Co., Ltd, 2001. 7: p. 116-124.

Balkaya, M., et al., Effects of Alcohol and Passive Smoking on Some Hematological Variables of Swiss Albino Mice. Turkish Journal of Veterinary Animal Science, 2005. 29: p. 241-250.

Chu, Y.C., Haematological Effects of Alcohol. Journal of the Hong Kong Medical Association, 1989. 41(1): p. 41-42.

Cook, R.T., Alcohol abuse, alcoholism, and damage to the immune system--a review. Alcoholism: Clinical Experimental Research, 1998. 22: p. 1927-1942.

Latvala, J., Effect of alcohol consumption and acetaldehyde on blood cells and molecules. Acta University of Tampere. Thesis. http://acta.uta.fi/pdf/951-44-6095-2.pdf, 2004.

Anders, H., T. Boris, and W.I.s. centres, Biochemical markers of alcohol use and abuse: Experience from the pilot study of the WHO/ISBRA Collaborative Project on State and Trait Markers of Alcohol. Alcohol and Alcoholism., 1997. 32(2): p. 133-144.

Chalmers, D.M., et al., Sex-related differences in the haematological effects of excessive alcohol consumption. Journal of Clinical Patholology., 1980. 33: p. 3-7.

Babor, T.F., et al., The Alcohol Use Disorders Identification Test (AUDIT) Manual: Guidelines for Use in Primary Care. Second Edition. Department of Mental Health and Substance Dependence. World Health Organization 2001. WHO/MSD/MSB/01.6a., 2001: p. 4-32.

Gonzalez-Casas, R., E.A. Jones, and R. Moreno-Otero, Spectrum of anemia associated with chronic liver disease. World Journal of Gastroenterology ISSN 1007-9327. www.wjgnet.com, 2009. 15(37): p. 4653-4658.

Antoniou, T. and A.L. Tseng, Interactions between recreational drugs and antiretroviral agents. HIV Program/Inner City Health, St. Michael's Hospital, Toronto, Ontario, Canada. Annals of Pharmacotherapy 2002. 36(10): p. 1598-613.

Brunton, L.L., J.S. Lazo, and K.L. Parker, Antiretroviral agents and treatment of HIV infection. Goodman and Gilman's The Pharmacological Basis of Therapeutics. 11th edition. 2006: p. 1273-1309.

Hoetelmans, R.M.W., Clinical Pharmacokinetics of Antiretroviral Drugs. AIDS Reviews., 1999. 1: p. 167-178.

Orrick, J.J., Antiretroviral drug interactions. Infectious Diseases: HIV/AIDS Primary care guide, Florida Aids Education and Training Centre, University of Florida. , 2002. 7: p. 69-81.

Chavez, M.L., K.J. MacKinnon, and L.S. Swanson, Herbal - Drug Interactions. INET Continuing Education (InetCE), 2005. 9(10): p. 1-30.

Fugh-Berman, A., Herbal-Drug interactions. The Lancet, 2000;355:134-138.

Bartlett, J.G. and J.E. Gallant, Medical Management of HIV Infection. Johns Hopkins University School of Medicine. Johns Hopkins Medicine Health Publishing Business Group. Baltimore, USA. 2005-2006., 2006.

Lima, V.D., et al., Association between HIV-1 RNA Level and CD4 Cell Count Among Untreated HIV-Infected Individuals. Research and Practice. American Journal of Public Health. 2009. 99(S1): p. S193-S196.

Madge, S., et al., HIV in Primary Care: An essential guide to HIV for GPs, practice nurses and other members of the primary healthcare team. Medical Foundation for AIDS and Sexual Health (MedFASH) 2004. London, UK., 2005: p. 11-67.

SAMHSA, The role of Biomarkers in the treatment of alcohol use disorders. Substance Abuse and Mental Health Service Administration: US Center for substance abuse treatment. 2006. 5(4).

Sawyer, S.M., et al., Laboratory Measures of Alcohol (Ethanol) Consumption: Strategies to Assess Drinking Patterns with Biochemical Measures. Biological Research for Nursing, 2003. 4(3).

Szabo G, et al. Levels of Carbohydrate-Deficient Transferrin according to Gender and Age in a Small Town in Hungary. CEMED 2009;3(2):319-25.