Infection Risk and Alcohol Use

AUDs affect the innate and adaptive immune response of the human body. Examples include defective monocyte oxidative burst and impaired phagocytosis which are associated with increased risk of infection and death. Behavioural factors linked with heavy alcohol consumption including injecting drug use, tobacco smoking, risky sexual practice, and forgetting to use condoms have a harmful impact on the risk of acquiring infectious diseases. There is a dose-response causal relationship between alcohol use and risk of communicable disease transmission including community acquired pneumonia, tuberculosis (TB), HIV/AIDS, and other sexually transmitted infections (STIs). 

Adherence to TB and HIV therapy is impaired in the setting of AUD. This increases transmission transmission risk and impairs both individual patient outcomes and public health measures to contain important infectious diseases. Focusing on reducing alcohol use is an essential component of infectious disease control strategies to improve immune response to infection, reduce the incidence of alcohol-related STI and also improve treatment adherence. Clinicians treating patients with STIs should screen for AUD, aiming at abstinence to improve treatment adherence, reduce risks and achieve better clinical prognosis. 

Chapter Recommendation Grade of recommendation
22.7 Delivering focused education about unprotected sex and risks for HIV/AIDS and other preventable STIs is recommended for persons with alcohol use disorders and/or high-risk alcohol use. B