Medical Marijuana And Human Immunodeficiency Virus

The human immunodeficiency virus (HIV) is a retrovirus that invades cells in the immune system of human beings, making it highly susceptible to infectious diseases. Over 500,000 Americans have died from HIV/AIDS and over one million US citizens are living with the disease, according to the World Health Organization.

Survey data suggests that cannabis is used by as many as one in three patients from North America with HIV/AIDS for treating symptoms of the disease as well as the side-effects of various antiretroviral medications. It was reported by a recent study that more than 60 percent of HIV/AIDS patients self-identify as “medical cannabis users.”

Patients suffering with HIV/AIDS most frequently report using cannabis for countering symptoms of anxiety, nausea, and appetite loss. At least one study has reported that patients who use cannabis therapeutically are 3.3 times more likely to adhere to their antiretroviral therapy regimens than non-cannabis users.

Use of cannabis does not adversely impact CD4 and CD8 T cell counts and could even improve immune function, according to clinical data.

Investigators at Columbia University published clinical trial data in 2007 and reported that HIV/AIDS patients who inhaled cannabis four times daily experienced “substantial … increases in food intake … with little evidence of discomfort and no impairment of cognitive performance.” They concluded, “Smoked marijuana … has a clear medical benefit in HIV-positive [subjects].”

In the same year, it was reported by investigators at San Francisco General Hospital and the University of California’s Pain Clinical Research Center in the journal Neurology that HIV-associated neuropathy is significantly reduced with inhaling cannabis compared to placebo. It was reported by researchers that inhaling cannabis three times daily reduced patients’ pain by 34 percent. They concluded, “Smoked cannabis was well tolerated and effectively relieved chronic neuropathic pain from HIV-associated neuropathy [in a manner] similar to oral drugs used for chronic neuropathic pain.”

Researchers at the University of California at San Diego reported similar finding while writing in the journal Neuropsychopharmacology in 2008. They concluded: “Smoked cannabis … significantly reduced neuropathic pain intensity in HIV-associated … polyneuropathy compared to placebo, when added to stable concomitant analgesics. … Mood disturbance, physical disability and quality of life all improved significantly during study treatment. … Our findings suggest that cannabinoid therapy may be an effective option for pain relief in patients with medically intractable pain due to HIV.”
Many experts, as a result, now believe that “marijuana represents another treatment option in [the] health management” of patients with HIV/AIDS.

[1] Woolridge et al. 2005. Cannabis use in HIV for pain and other medical symptoms. Journal of Pain Symptom Management 29: 358-367.
[2] Prentiss et al. 2004. Patterns of marijuana use among patients with HIV/AIDS followed in a public health care setting [PDF]. Journal of Acquired Immune Deficiency Syndromes 35: 38-45.
[3] Braitstein et al. 2001. Mary-Jane and her patients: sociodemographic and clinical characteristics of HIV-positive individuals using medical marijuana and antiretroviral agents. AIDS 12: 532-533.
[4] Ware et al. 2003. Cannabis use by persons living with HIV/AIDS: patterns and prevalence of use. Journal of Cannabis Therapeutics 3: 3-15.
[5] Belle-Isle and Hathaway. 2007. Barriers to access to medical cannabis for Canadians living with HIV/AIDS. AIDS Care 19: 500-506.
[6] de Jong et al. 2005. Marijuana use and its association with adherence to antiretroviral therapy among HIV-infected persons with moderate to severe nausea. Journal of Acquired Immune Deficiency Syndromes 38: 43-46.
[7] Chao et al. 2008. Recreational drug use and T lymphocyte subpopulations in HIV-uninfected and HIV-infected men. Drug and Alcohol Dependence 94:165-171.
[8] Rachiel Schrier. 2010. Effects of medicinal cannabis on CD4 immunity in AIDS. In: University of San Diego Health Sciences, Center for Medicinal Cannabis Research. Report to the Legislature and Governor of the State of California presenting findings pursuant to SB847 which created the CMCR and provided state funding. op. cit.
[9] Abrams et al.2003. Short-term effects of cannabinoids in patients with HIV-1 infection: a randomized, placebo-controlled clinical trial. Annals of Internal Medicine 139: 258-266.
[10] Fogarty et al. 2007. Marijuana as therapy for people living with HIV/AIDS: social and health aspects 19: 295-301.
[11] Haney et al. 2007. Dronabinol and marijuana in HIV-positive marijuana smokers: caloric intake, mood and sleep. Journal of Acquired Immune Deficiency Syndromes 45: 545-554.
[12] Abrams et al. 2007. Cannabis in painful HIV-associated sensory neuropathy: a randomized placebo-controlled trial.
[13] Ellis et al. 2008. Smoked medicinal cannabis for neuropathic pain in HIV: a randomized, crossover clinical trial. op. cit.
[14] Fogarty et al. 2007. op. cit.

Inhaled Cannabis Modulates Appetite Hormones In HIV Patients

According to clinical trial data published online in the scientific journal Brain Research, cannabis inhalation is associated with increased levels of appetite hormones in the blood of subjects with HIV infection.

The effects of inhaled cannabis on the appetite hormones ghrelin, leptin and peptide YY (PYY), as well as insulin, in adult subjects with HIV were assessed by investigators at the University of California, San Diego and the Center for Medicinal Cannabis Research. Insulin, ghrelin, PYY, and leptin are hormones individually modulated in response to intake of food and energy homeostasis.

Researchers reported: “Compared to placebo, cannabis administration was associated with significant increases in plasma levels of ghrelin and leptin, and decreases in PYY, but did not significantly influence insulin levels. … Cannabis-related changes in these hormones had a magnitude similar to what has been observed with food intake over the course of a day in normal volunteers, suggesting physiological relevance.”
They concluded, “These findings support further evaluations of interventions directed at manipulating the endocannabinoid system for the treatment of eating disorders and obesity.”

A pilot study of the effects of cannabis on appetite hormones in HIV-infected adult men-Brain Research