Q and A

Question

Will alcohol make my HIV meds less effective?

I am confused about alcohol and whether it is advisable to drink when I am on meds. I am on atazanavir, ritonavir & Truvada and since starting my meds (5 months ago) I havent had a drop of alcohol. I have wanted to take care of myself (as I have always in the past) and not put unnecessary burden on my body and liver esp now that I am on these heavy burdensome drugs.

However, I now really want to have a drink – not a lot, but a drink now and again. am I allowed to? I read a lot of confliciting articles – some say dont drink at all and other say yes you can have a drink. I feel that I should not have anything and I really need to look after myself even more now but I would like to have a drink with dinner or when out with friends.

What guidelines are there? and, more importantly, will it make my meds less effective?

many thanks for your help, support & advice

Answer

Thanks for your questions that are important for lots of people.

The reason for some of conflicting articles you have read are likely to be related to how much someone might drink.

On the one hand, there is no direct interaction between HIV meds and alcohol. Unlike some other recreational drugs, alcohol doesn’t increase or decrease levels of HIV drugs. It is fine to take your meds with a beer, or to have a few drinks over dinner with friends.

Guidelines for HIV-positive people are therefore the same as for the general population.

Here is a link to information about UK recommendations.

Here is a link to an online calculator to see how much you drink.

The NHS recommends:

  • Men should not regularly drink more than 3-4 units of alcohol a day
  • Women should not regularly drink more than 2-3 units a day

‘Regularly’ means drinking this amount every day or most days of the week.

However, while your HIV meds work just as well with or without a drink, you might not work as well :)

Lots of studies have linked routine or heavy alcohol use with a risk of lower adherence – missing doses of your meds – and this then increases the risk of drug resistance and treatment failure.

For some people and in some communities, alcohol is such a significant social problem that alcohol use is an exclusion criteria for accessing HIV treatment.

I’d also add a comment to your reference to HIV drugs being ‘liver burdensome drugs’. This is a common misconception and often scares people from using treatment that is actually very safe.

You liver is built to filter all sort of toxicities. This includes toxicities from medicines, herbs, alcohol, cigarette smoke and food etc. It is usually a good study organ. Although HIV drugs, like any medicine, have the potential in some people to affect the way your liver functions, for most people they have little or no impact.

Routine monitoring on treatment includes checking liver enzyme levels (usually LFT or AFT) and very few people need to switch or stop treatment because of liver problems. When problems develop, these are almost exclusively in people who also have viral hepatitis infections (especially HepB or HepC) or where heavy alcohol use has caused problems.

27 comments

  1. Lisa Thorley

    Hi Andries,

    Drinking won’t stop the ARVs from worling.

  2. Andries

    I was on PEP and had some heavy drinks for few days but I didn’t skip my doses.Am I at risk?

  3. Lisa Thorley

    Hi Inno,

    What your doctor has told you is wrong.
    If you’re positive and your partner is negative then you won’t have contracted HIV from them.

    Are you currently on medication? If you are and your viral is undetectable you can’t transmit HIV through sexual intercourse. Please see here for more info:

    http://i-base.info/htb/32308

    If however your viral load is detectable then yes he is at risk. This is his risk to take and not yours, that is if he’s aware of your status.

  4. Inno

    I recently tested positive and my partner is negative, we love each other but he refuses to use condoms when we want to have sex…what are the chances of him being positive…. He cheated me with a positive lady, about two years ago and i never cheated on him….when we went to test this year i tested positive and him negative then the doctor told us that other people are carriers of hiv even if they are positive some times it doesn’t show when they get tested.. How true is this… He love and support me

  5. Lisa Thorley

    Hi Luis,

    Its perfectly fine to have a few beers, they won’t affect your meds. Just remember to take them.

  6. Luis

    I am taking Truvada 200-300 mg tabs + isentress 400 mg tabs and was wondering if I could drink at least one beer per day?? I’ve been craving one since the longest lol..
    Would it affect my medication process??
    Thank you

  7. Lisa Thorley

    Hi loveson,

    Please see questions 1 and 8 here:

    http://i-base.info/qa/what-are-the-most-asked-questions

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