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.

57 comments

  1. Kate

    Hi, I was told by my doctor that alcohol affect ARV drugs and there by causes resistance. Is it true?

  2. Roy Trevelion

    Hi Clive,

    Sorry, but there is no medical scientific evidence to support coffee enemas. In fact they can cause infections and, if the coffee is too hot, internal burning.

    As Simon says here, very few people need to switch ARVs because of liver problems. These problems are almost exclusively in people who also have viral hepatitis infections (especially HepB or HepC) or where heavy alcohol use has caused problems.

    It’s a good idea talk to your doctor about your raised liver enzymes. You can check if they are only mildly raised and if this is significant for your liver health.

  3. Clive

    Can I use an enema while on ARV’S I have just started on my ARV’S and also found that my liver enzymes are higher than normal then when doing a research I found that coffee enema is good for liver.im confused because of some articles that say dont use enema if u are hiv+ pls advise

  4. Roy Trevelion

    Hi Caroline,
    Is your viral load undetectable? Undetectable means under 50 copies/mL. If you have been undetectable for several months HIV cannot be transmitted even without using condoms. You can read more about Undetectable = Untransmittable (U=U) at this link.

  5. Caroline

    Am HIV positive nd my panter know about this but he don’t want to use condom nd am taking ARVS nd he doesn’t am I safe with this

  6. James

    Taking alcohol is not the major problem, But when one takes excess alcohol to a point where one can’t reason well, may lead to one skipping the actual time for taking drugs.

  7. Lisa Thorley

    Hi Yoli,

    Yes you can drink alcohol, this won’t affect your immune system. The important thing is to make sure that you don’t miss your meds when drinking.

  8. Yoli

    I have been medications for about 1 year 2 months now .pls I wish to know if I having a sip of alcohol will have a problem or damage in my immune system.

  9. Lisa Thorley

    Hi Joy,

    As long as your viral load is undetectable, there won’t be any risk. Do you know what it is? If its detectable, then yes there is a risk.
    If you think you contracted HIV from your partner, then maybe this is something to talk to him about and in a direct way.

  10. Joy

    I found out am hiv positive some months back and have been on medication but have not been able to tell my partner direct but have been using other medium to try and tell him. Though I think he was the one that gave me the disease because we always use a condom due to unwanted pregnancy but 3 months ago we had unprotected sex due to alcohol effect, after some weeks I started having the symptoms but to cut the long story short 3 days ago we were having sex and the condom loosed so I want to know if that would be a problem since am the only one on medication

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