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Marijuana Use Does Not Accelerate HIV Infection

01 April, 2008

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ISLAMABAD: Short-term cannabis use does not seem to adversely affect CD4+ cell counts or viral loads in HIV -infected patients, according to a report published in the August 19th issue of the Annals of Internal Medicine.

In HIV-infected patients, marijuana has been used as an appetite stimulant and as a treatment for the nausea associated with some antiretroviral agents. However, concern has been raised that such therapy could have a harmful effect on disease status, because in theory, cannabinoid use could increase HIV levels by impairing the immune response or by interfering with the activity of protease inhibitors.

Previously it was shown that short-term marijuana use did not influence nelfinavir metabolism. Although marijuana use did produce a drop in indinavir levels, this fall was small and unlikely to be clinically meaningful. However, it still remained unclear whether cannabinoid use had an effect on viral load or CD+ cell counts.

To investigate, Dr. Donald I. Abrams, from the University of California at San Francisco, and colleagues assessed the outcomes of 67 HIV-infected patients who were randomly assigned to use marijuana cigarettes, cannabinoid capsules, or sugar pills (placebo) three times daily for 21 days. All of the patients had been receiving the same antiretroviral regimen, which included indinavir or nelfinavir, for at least 8 weeks before the study began.

More than half of the subjects in each group had undetectable viral loads throughout the study, the researchers note. Although not statistically significant, marijuana and cannabinoid use were actually associated with a slight drop in viral load compared with placebo use.

Marijuana and cannabinoid use did not produce a drop in CD4+ or CD8+ cell counts. In fact, compared with placebo use, treatment with these agents was actually associated with a slight increase in cell counts.

The results suggest that short-term cannabinoid use is not unsafe for patients with HIV infection, the authors note. "Further studies investigating the therapeutic potential of marijuana and other cannabinoids in patients with HIV infection and other populations are ongoing and should provide additional safety information over longer exposure periods," they write.

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