Abstract
This chapter focuses on alcohol use disorders (AUDs). Approximately 18 million adults in the United States meet the criteria for AUD. The authors point out that patients with AUD have an increased susceptibility to bacterial infections such as pneumonia, tuberculosis, peritonitis, and bacteremia, and individuals with AUD are more likely to develop viral hepatitis and HIV disease. The chapter explains how alcohol consumption can alter microbial communities of the gastrointestinal tract and the respiratory tree, including the oropharynx, mainstem bronchus, and lower bronchoalveolar spaces. The authors suggests that the immunotoxic effects of ethanol are caused by direct cytotoxicity and by a shift in the balance of cytokines produced from the proinflammatory to more immunoinhibitory products.