Pubdate: Tue, 18 Aug 2003
Source: Reuters (Wire)
Copyright: 2003 Reuters Limited

MARIJUANA USE DOES NOT ACCELERATE HIV INFECTION

NEW YORK (Reuters Health) - Short-term cannabis use does not seem to
adversely affect CD4+ cell counts or viral loads in HIV (news - web
sites)-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 (see Reuters Health story March 20, 2002).
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. SOURCE: Annals of Internal Medicine,
August 9, 2003.
- ---
MAP posted-by: Larry Seguin