Alcohol Consumption and Tryptophan Metabolism Among People with HIV Prior to Antiretroviral Therapy Initiation: The Uganda ARCH Cohort Study

Frantz Pierre; Leah S Forman; Michael Winter; Debbie Cheng; Christine Ngabirano; Nneka Emenyonu; Peter W Hunt; Yong Huang; Winnie Muyindike; Jeffrey Samet; Judith A Hahn; Kaku So-Armah

doi:10.1093/alcalc/agab033

Alcohol Consumption and Tryptophan Metabolism Among People with HIV Prior to Antiretroviral Therapy Initiation: The Uganda ARCH Cohort Study

Alcohol Alcohol. 2021 May 24;agab033. doi: 10.1093/alcalc/agab033. Online ahead of print.

Authors

Affiliations

¹ Department of Epidemiology and Biostatistics, Boston University School of Public Health, 72 E Concord St, Boston, MA 02118, USA.
² Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, 85 East Newton Street, M921, Boston, MA 02118, USA.
³ Department of Biostatistics, Boston University School of Public Health, 801 Massachusetts Ave Boston, MA 02119, USA.
⁴ Mbarara University of Science and Technology Department of Internal Medicine P.O Box 1410 Mbarara Uganda, Uganda.
⁵ Department of Medicine, University of California San Francisco, 1001 Potrero Ave, San Francisco, CA 94110, USA.
⁶ Division of HIV/AIDS, San Francisco General Hospital, San Francisco, CA, USA.
⁷ Department of Bioengineering and Therapeutics, University of California San Francisco, 1700 4th Street, San Francisco, CA 94158, USA.
⁸ Mbarara University of Science and Technology Department of Internal Medicine P.O Box 1410 Mbarara, Uganda.
⁹ Department of Medicine, Boston University School of Medicine and Boston Medical Center, 801 Massachusetts Ave Crosstown, 2nd Floor Boston, MA 02118, USA.
¹⁰ Departments of Medicine and Epidemiology & Biostatistics, University of California San Francisco, 550 16th St., 3rd floor San Francisco, CA 94158-2549, USA.
¹¹ Department of Medicine, Boston University School of Medicine, 801 Massachusetts Ave, 2nd Floor Boston, MA 02118, USA.

PMID: 34027552
DOI: 10.1093/alcalc/agab033

Abstract

Aims: Alcohol is hypothesized to have effects on the kynurenine pathway of tryptophan catabolism, a potential mechanism for alcohol-induced depression and aggression. A biomarker of this pathway, the plasma kynurenine to tryptophan ratio (K/T ratio), has been associated with HIV progression, mortality and depression. Our aim was to assess whether hazardous alcohol consumption is associated higher K/T ratio among people with HIV.

Methods: Participants were a subset of the Uganda Alcohol Research Collaboration on HIV/AIDS Cohort. Alcohol consumption was categorized (abstinent, moderate and hazardous alcohol use) using the Alcohol Use Disorders Identification Test-Consumption and phosphatidylethanol (PEth). K/T ratio was the primary outcome. We used linear regression adjusted for age, sex, FIB-4, hepatitis B surface antigen, log (HIV viral load) to estimate the association between alcohol consumption and K/T ratio.

Results: Compared to abstinent participants, hazardous drinkers and moderate drinkers had higher K/T ratio but these differences did not reach statistical significance.

Conclusions: Our results suggest that hazardous alcohol consumption, in the context of untreated HIV infection, may not significantly alter kynurenine to tryptophan ratio as a measure of activity of the kynurenine pathway of tryptophan metabolism.