Alcohol Use and the Risk of Communicable Diseases

Abstract

The body of knowledge on alcohol use and communicable diseases has been growing in recent years. Using a narrative review approach, this paper discusses alcohol’s role in the acquisition of and treatment outcomes from four different communicable diseases: these include three conditions included in comparative risk assessments to date—Human Immunodeficiency Virus (HIV)/AIDS, tuberculosis (TB), and lower respiratory infections/pneumonia—as well as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) because of its recent and rapid ascension as a global health concern. Alcohol-attributable TB, HIV, and pneumonia combined were responsible for approximately 360,000 deaths and 13 million disability-adjusted life years lost (DALYs) in 2016, with alcohol-attributable TB deaths and DALYs predominating. There is strong evidence that alcohol is associated with increased incidence of and poorer treatment outcomes from HIV, TB, and pneumonia, via both behavioral and biological mechanisms. Preliminary studies suggest that heavy drinkers and those with alcohol use disorders are at increased risk of COVID-19 infection and severe illness. Aside from HIV research, limited research exists that can guide interventions for addressing alcohol-attributable TB and pneumonia or COVID-19. Implementation of effective individual-level interventions and alcohol control policies as a means of reducing the burden of communicable diseases is recommended.

Potenzielle Auswirkungen erhöhter Alkoholsteuern auf die alkoholbedingte Krankheitslast in Deutschland: Eine Modellierungsstudie

“… Für Infektionskrankheiten (humane Immundefizienzviruskrankheit (HIV), ICD-10: B20–B24; Tuberkulose, ICD-10: A15–A19, B90; sowie für Infekte der unteren Atemwege, ICD-10: J09–22, P23, U04) wurden ausschließlich vermeidbare Krankheitsfälle, jedoch keine vermeidbaren Todesfälle modelliert. Diese Entscheidung wurde getroffen, da sich der unmittelbare Einfluss von Änderungen im Alkoholkonsum bei der Entstehung von Infektionskrankheiten besser quantifizieren lässt als für Todesfälle [ 25 ]. Es standen keine Daten zur Inzidenz von Hypertonie zur Verfügung, weshalb ausschließlich die vermeidbare alkoholbedingte Mortalität geschätzt wurde.…”

The Impact of Alcohol Control Policy on Pneumonia Mortality in Lithuania: An Interrupted Time-Series Analysis

“…The mechanism by which alcohol consumption increases the risk of pneumonia is through weakening the immune system and increasing the host's susceptibility to infection [3]. The causal pathways leading to alcohol-attributable pneumonia via compromised immunity are numerous and primarily target the key immune cells involved in combatting respiratory conditions, known as neutrophils, lymphocytes, macrophages, and other cells inherently responsible for immune responses [3]. A meta-analysis by Simou et al [7] found that the risk of community-acquired pneumonia significantly increased in people who consumed alcohol compared to those who did not (relative risk (RR) = 1.61, 95% confidence interval (CI) 1.25 to 2.08), and that for every 10-20 g higher alcohol intake per day, the risk of community-acquired pneumonia increased by 8% [7].…”

“…Pneumonia, as defined by the World Health Organization (WHO), is a form of respiratory infection that causes inflammation in the lungs, limits oxygen intake and consequently makes breathing difficult [ 1 ]. Pneumonia, together with other lower respiratory infections, was considered the fourth leading cause of death worldwide in 2019 [ 2 ] and had a significant overall disease burden, with an estimated 2.5 million deaths globally and approximately 97 million disability-adjusted life years (DALYs) [ 3 ]. It is estimated that in Europe in 2003, the cost of pneumonia was approximately ten billion euros annually, with the indirect cost due to lost productivity accounting for 3.6 billion euros [ 4 ].…”

“…Alcohol consumption has been recognised as one of several risk factor for pneumonia [ 6 ]. The mechanism by which alcohol consumption increases the risk of pneumonia is through weakening the immune system and increasing the host's susceptibility to infection [ 3 ]. The causal pathways leading to alcohol-attributable pneumonia via compromised immunity are numerous and primarily target the key immune cells involved in combatting respiratory conditions, known as neutrophils, lymphocytes, macrophages, and other cells inherently responsible for immune responses [ 3 ].…”

The Impact of Alcoholic Beverages on Human Health

“…Increases the risk of a range of communicable diseases, including HIV, TB, pneumonia, and COVID-19 infection [9]; and • May or may not increase the risk of overweight and obesity [10].…”