HIV & AIDS – Medical Marijuana Research Overview

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HIV is a typically asymptomatic virus that causes AIDS and interferes with the body’s ability to fight infections. Research shows cannabis helps patients manage symptoms associated with HIV and AIDS treatments and may even help slow the progression of the virus.

Overview of HIV

HIV, or human immunodeficiency virus, spreads through body fluids and specifically attacks the immune system’s CD4 cells (also known as “T cells”), gradually destroying them and making the body less effective at combating diseases and infections. Untreated, HIV can progress to AIDS, or acquired immunodeficiency syndrome, which is the stage of HIV infection when your immune system is considerably damaged and T cells fall below 200 cells per cubic millimeter of blood (200 cells/mm3). With AIDS, even diseases and infections that are easily combated by healthy individuals pose a threat that can be fatal.

HIV is transmitted through the transfer of body fluids, including blood, semen, pre-seminal fluid, vaginal fluids, rectal fluids, and breast milk. In the United States, HIV is most commonly spread through sex or sharing an injection needle with someone with HIV.

According to the U.S. Department of Health & Human Services, more than 1.2 million people in the United States are living with the HIV infection and nearly 1 in 8 are unaware that they are infected. Despite potentially experiencing an initial bout of flu-like symptoms during the first two to four weeks after infection, many of those infected never report symptoms for 10 years or more. The only way to determine whether one is infected with HIV is through testing. Health care providers can provide an HIV test and there are home test kits available. A number of organizations, including the Centers for Disease Control and Prevention (CDC), offer free testing.

There is currently no effective cure for HIV, so once its acquired, the focus of treatment is on controlling the virus and preventing it from progressing to AIDS. A person who has AIDS must receive treatment to prevent death.

While antiretroviral therapy has been shown to effectively curtail HIV from progressing to AIDS, the symptoms and side effects of the long-term drug therapy are considerable. Nausea, vomiting, diarrhea, heart disease, weakened bones, muscle tissue breakdown, and neuropathic pain are commonly reported during HIV treatment regimens. Weight loss due to nausea and a loss of appetite compounds weaknesses in the immune system.

Findings: Effects of Cannabis on HIV

While the side effects of HIV and AIDS treatments can impinge on one’s life quality, studies have shown that medical marijuana can help make the adverse effects more manageable. HIV positive patients consuming medical marijuana have reported significant improvements in appetite, muscle pain levels, nausea, anxiety, depression, and skin tingling9. Studies have found that daily and chronic neuropathic pain related to HIV can be significantly lowered by regular cannabis consumption1,4. Medical marijuana also boosts appetite and daily functioning, helping to combat weight loss and muscle breakdown5.

Research also suggests that consuming medical marijuana is safe for patients with HIV/AIDS. One study found no significant association with cannabis use and the CD4 T-cell count of patients co-infected with HIV and HCV, suggesting cannabis has no adverse effects on the immune system6. Another study found that patients with an HIV/HCV co-infection that smoked marijuana were at no greater risk of liver fibrosis2.

While research surrounding marijuana’s potential treatment effects on the HIV virus itself, a recent study discovered that marijuana-like compounds blocked the spread of HIV virus during the late stages of the infection3. Results from an animal trial also contribute to the theory that marijuana might be able to stop the spread of HIV. Monkeys that were infected with an animal form of the virus and administered with THC for 17 months saw a decrease in damage to the immune tissue of the stomach7.

States That Have Approved Medical Marijuana for HIV

Nearly all U.S. states will medical marijuana laws have approved medical marijuana for the treatment of HIV/AIDS. These states include: Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Hawaii, Illinois, Louisiana, Maine, Massachusetts, Michigan, Minnesota, Montana, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Dakota, Ohio, Pennsylvania, Oregon, Rhode Island, Vermont and Washington.

In Maryland, medical marijuana may be prescribed for patients of any disease or condition that causes chronic pain.

In Washington D.C., any condition can be approved for medical marijuana as long as a DC-licensed physician recommends the treatment.

Findings from Recent Studies on Cannabis’ Effect on HIV
  • Marijuana-like compounds can block the spread of HIV virus throughout the body during infection’s late stages.
    Cannabinoid Receptor 2-Mediated Attentuation of CXCR4-Tropic HIV Infection in Primary CD4+ T Cells 
    (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3309010/)
  • Smoking cannabis found to reduced HIV-associated daily pain levels by 34% and chronic pain levels by a median of 72%.
    Cannabis in painful HIV-associated sensory neuropathy: a randomized placebo-controlled trial 
    (http://www.ncbi.nlm.nih.gov/pubmed/17296917)
  • HIV-positive patients treated with medical marijuana report significant improvement in appetite, muscle pain, nausea, anxiety, nerve pain, depression and paresthesia.
    Cannabis use in HIV for pain and other medical symptoms. 
    (http://www.ncbi.nlm.nih.gov/pubmed/15857739)
  • Marijuana found to cause substantial increases in food intake in HIV positive patients that suffered from significant muscle loss, without any negative side effects.
    Dronabinol and marijuana in HIV(+) marijuana smokers: acute effects on calorie intake and mood. 
    (http://www.ncbi.nlm.nih.gov/pubmed/15778874)
  • Marijuana found to cause increase in daily caloric intake and body weight and an improved rating of sleep in HIV-positive individuals.
    Dronabinol and marijuana in HIV-positive marijuana smokers. Calorie intake, mood, and sleep. 
    (http://www.ncbi.nlm.nih.gov/pubmed/17589370)
  • Cannabis found to have no ill-effects on CD4 cell counts in HIV-positive individuals.
    Short-term effects of cannabinoids in patients with HIV-1 infection: a randomized, placebo-controlled clinical trial. 
    (http://www.ncbi.nlm.nih.gov/pubmed/12965981)
  • HIV-infected individuals consuming medical marijuana four times per day for five consecutive days reported greater pain relief and improvements in mood and daily functioning.
    Smoked Medicinal Cannabis for Neuropathic Pain in HIV: A Randomized, Crossover Clinical Trial
    (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3066045/)

References

  1. Abrams, D.I., Jay, C.A., Shade, S.B., Vizoso, H., Reda, H., Press, S., Kelly, M.E., Rowbotham, MC. and Petersen, KL. (2007, February). Cannabis in painful HIV-associated sensory neuropathy: a randomized placebo-controlled trial. Neurology, 68(7), 515-21.
  2. Brunet, L., Moodie, E.E.M., Rollet, K., Cooper, C., Walmsley, S., Potter, M., Klein, M.B., for the Canadian Co-infection Cohort Investigators. (2013). Marijuana Smoking Does Not Accelerate Progression of Liver Disease in HIV–Hepatitis C Coinfection: A Longitudinal Cohort Analysis. Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America, 57(5), 663–670. http://doi.org/10.1093/cid/cit378
  3. Costantino, C.M., Gupta, A., Yewdall, A., Dale, B., Devi, L., and Chen, B. (2012) Cannabinoid Receptor 2-Mediated Attentuation of CXCR4-Tropic HIV Infection in Primary CD4+ T Cells. PLoS One, 7(3), e33961.
  4. Ellis, R., Toperoff, W. Vaida, F., van den Brande, G., Gonzales, J., Gouaux, B., Bentley, H. and Atkinson, J. (2008, February) Smoked Medicinal Cannabis for Neuropathic Pain in HIV: A Randomized, Crossover Clinical Trial. 34(3), 672-680.
  5. Haney, M., Rabkin, J., Gunderson, E., and Foltin, RW. (2005, August). Dronabinol and marijuana in HIV(+) marijuana smokers: acute effects on caloric intake and mood. Psychopharmacology, 181(1), 170-8.
  6. Marcellin, F., Lions, C., Rosenthal, E., Roux, P., Sogni, P., Wittkop, L., Protopopescu, C., Spire, B., Salmon-Ceron, D., Dabis, F., Carrieri, M.P., for the HEPAVIH ANRS CO13 Study Group. (2016, April 13). No significant effect of cannabis use on the count and percentage of circulating CD4 T-cells in HIV-HCV co-infected patients (ANRS CO13-HEPAVIH French cohort). Drug and Alcohol Review, doi: 10.1111/dar.12398. [Epub ahead of print]
  7. Molina, P.E., Amedee, A.M., LeCapitaine, N.J., Zabaleta, J., Mohan, M., Winsauer, P.J., Vande Stouwe, C., McGoey, R.R., Auten, M.W., LaMotte, L., Chandra, L.C., and Birke, L. L. (2014). Modulation of Gut-Specific Mechanisms by Chronic Δ9-Tetrahydrocannabinol Administration in Male Rhesus Macaques Infected with Simian Immunodeficiency Virus: A Systems Biology Analysis. AIDS Research and Human Retroviruses, 30(6), 567–578. http://doi.org/10.1089/aid.2013.0182
  8. S. Statistics. (n.d.). AIDS.gov. Retrieved from https://www.aids.gov/hiv-aids-basics/hiv-aids-101/statistics/.
  9. Woodridge, E., Barton, S., Samuel, J., Osario, J., Dougherty, A. and Holdcroft, A. (2005, April 20). Cannabis use in HIV for pain and other medical symptoms. Journal of Pain and Symptom Management, 29(4), 358-67.

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