Introduction: The advent of combination antiretroviral therapy(cART) has lead to a significant reduction in
morbidity and mortality among people living with HIV(PLWH). However, HIV-associated neurocognitive disorders
(HAND) still remain a significant problem. One possible mechanism for the persistence of these disorders is through the
effect of HIV on brain-derived neurotrophic factor (BDNF). BDNF is influenced by various factors including hazardous
alcohol use (HAU), which is prevalent among PLWH. This study attempts to elucidate the relationships between HAU,
BDNF and HAND.
Methods: Cross-sectional analyses were conducted on a sample of 199 hazardous alcohol users and 198 non-HAU living
with HIV. Members of each group were matched according to sociodemographic characteristics and CD4 count. Research
procedures included validated questionnaires, neuropsychological assessments and a blood sample to obtain BDNF and
Results: Hazardous alcohol users showed either significantly lower or significantly higher BDNF levels compared to the
Non-hazardous (OR=1,4; 95% CI: 1-2.1, p = 0.003). Therefore, for additional analyses, subjects were categorized based
on BDNF values in: Group 1 < 4000, Group 2: 4001-7,999 (reference group), and Group 3 for those >8,000 pg/mL.
Groups 1 and 3 performed significantly worse than those in Group 2 in the domains of processing speed, auditory-verbal
and visuospatial learning and memory. Multivariate analyses confirmed that HAU and BDNF are significant contributors
Conclusion: Our findings offer novel insights into the relationships between BDNF, and alcohol use among PLWH. Our
results also lend support to expanding clinical movement to use BDNF as an intervention target for PLWH, in those with
evidence of deficiencies, and highlight the importance of including HAUat the inception of clinical trials.