The Relationships between Cholesterol, Tobacco and Alcohol Use : A New Opportunity for Intervention among People Living with HIV

Objective: Given increased evidence of cholesterol's role in the structure and functioning of the central nervous system, this study examines how lipid disturbances might deregulate drinking behaviors. Methods: Using a clinical cohort, the relationship between hypocholesterolemia and alcohol use was prospectively assessed over a period of 6 months while controlling for biological, familial, and intrapersonal factors. People Living with HIV (PLWH) were stratified according to baseline cholesterol levels: hypocholesterolemic (HypoCHL<150mg/dl) or nonHypoCHL (>150mg/dl). We used a Bayesian network model to analyze the probability that HypoCHL predicts alcohol trajectories. Results: At baseline, those participants with HypoCHL consumed more alcohol (29.9 ± 4 vs. 15.1 ± 2 drinks p=0.001) and on more days/week (4 ± 2.7 vs. 2.8 ± 2.5, p=0.002) than normal CHL participants. At the follow-up evaluation, alcohol consumption increased or remained constant in 60% of the sample and was associated with four risk factors: HypoCHL (OR = 1.5, p=0.04), cigarette smoking (OR = 2.9, p = 0.008), drinking liquor (OR = 1.9, p = 0.05), and having a close relative with hazardous alcohol use (OR =3, p=0.0001). The Bayesian model further predicted that if a subject has a baseline cholesterol level below 150 mg, that there would be an 87% probability of maintaining or increasing alcohol intake, and only a 14% chance of reducing intake during the study. Noteworthy, if cholesterol was modeled to be normal, the probability of reducing alcohol intake increased to 41%. Conclusion: This study provides evidence that HypoCHL is a significant predictor of increasing or continuing hazardous consumption of alcohol in PLWH.