Beyond the Brain: The Role of Brain-Derived Neurotrophic Factor in Viroimmune Responses to Antiretroviral Therapy among People Living with HIV with and without Alcohol Use

J Int Assoc Provid AIDS Care. 2014 Sep-Oct;13(5):454-60. doi: 10.1177/2325957414535253. Epub 2014 May 16.

Abstract

Objective: Given the emerging data suggesting the key role of brain-derived neurotrophic factor (BDNF) in the immune system, we assessed longitudinally whether BDNF depletions induced by hazardous alcohol use (HAU) would impact a response to antiretroviral therapy (ART).

Methods: In a prospective single-site cohort, virological and immunological responses to ART in 200 hazardous and 200 nonhazardous users were obtained, along with plasma BDNF levels.

Results: Hazardous drinkers were more likely to have BDNF levels <4000 pg/mL (odds ratio [OR] = 1.6, P = .01). Participants with BDNF <4000 pg/mL were less likely to have CD4 counts of more than 500 cells/mm(3) (P = .02) and to achieve viral suppression over the follow-up period (OR = 1.5, P = .03). Multivariate analysis confirmed the significant role of HAU and low BDNF in predicting viroimmune responses.

Conclusion: Hazardous alcohol use was associated with BDNF alterations, which in turn were linked to a limited response to ART in terms of viral suppression and CD4 count improvements.

Keywords: BDNF; CD4; HIV/AIDS; alcohol; viral load.

MeSH terms

  • Adult
  • Alcohol Drinking* / blood
  • Alcohol Drinking* / epidemiology
  • Anti-Retroviral Agents / therapeutic use*
  • Antiretroviral Therapy, Highly Active
  • Brain-Derived Neurotrophic Factor / blood*
  • CD4 Lymphocyte Count
  • HIV Infections* / drug therapy
  • HIV Infections* / epidemiology
  • HIV Infections* / immunology
  • HIV Infections* / virology
  • HIV-1
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Viral Load

Substances

  • Anti-Retroviral Agents
  • Brain-Derived Neurotrophic Factor
  • BDNF protein, human