The human immunodeficiency virus (HIV) is a lentivirus (a subgroup of retrovirus) that causes the acquired immunodeficiency syndrome (AIDS), a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive. Without treatment, average survival time after infection with HIV is estimated to be 9 to 11 years, depending on the HIV subtype. Infection with HIV occurs by the transfer of blood, semen, vaginal fluid, pre-ejaculate, or breast milk. Within these bodily fluids, HIV is present as both free virus particles and virus within infected immune cells.
HIV infects vital cells in the human immune system such as helper T cells (specifically CD4+ T cells), macrophages, and dendritic cells. HIV infection leads to low levels of CD4+ T cells through a number of mechanisms, including apoptosis of uninfected bystander cells, direct viral killing of infected cells, and killing of infected CD4+ T cells by CD8 cytotoxic lymphocytes that recognize infected cells. When CD4+ T cell numbers decline below a critical level, cell-mediated immunity is lost, and the body becomes progressively more susceptible to opportunistic infections.
Medical Marijuana Efficacy
One recent study reported that more than 60 percent of HIV/AIDS patients self-identify as “medical cannabis users.” Patients living with HIV/AIDS most frequently report using cannabis to counter symptoms of anxiety, appetite loss and nausea, and 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.
Clinical trial data indicates that cannabis use does not adversely impact CD4 and CD8 T cell counts and may even improve immune function.
In 2007, investigators at Columbia University published clinical trial data in 2007 reporting 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.”
Official Research Reports
A pilot study of the effects of cannabis on appetite hormones in HIV-infected adult men (Riggs PK, Vaida F, Rossi SS, Sorkin LS, Gouaux B, Grant I, Ellis RJ, 2012)
Marijuana use is not associated with cervical human papillomavirus natural history or cervical neoplasia in HIV-seropositive or HIV-seronegative women. (D’Souza G, Palefsky JM, Zhong Y, Minkoff H, Massad LS, Anastos K, Levine AM, Moxley M, Xue XN, Burk RD, Strickler HD, 2010)
Efficacy and tolerability of high-dose dronabinol maintenance in HIV-positive marijuana smokers: a controlled laboratory study. (Bedi G, Foltin RW, Gunderson EW, Rabkin J, Hart CL, Comer SD, Vosburg SK, Haney M, 20210)
Smoked medicinal cannabis for neuropathic pain in HIV: a randomized, crossover clinical trial. (Ellis RJ, Toperoff W, Vaida F, van den Brande G, Gonzales J, Gouaux B, Bentley H, Atkinson JH, 2009)
Dronabinol and marijuana in HIV-positive marijuana smokers: caloric intake, mood, and sleep. (Haney M, Gunderson EW, Rabkin J, Hart CL, Vosburg SK, Comer SD, Foltin RW, 2007)
Marijuana use and its association with adherence to antiretroviral therapy among HIV-infected persons with moderate to severe nausea. (de Jong BC, Prentiss D, McFarland W, Machekano R, Israelski DM, 2005)
Patterns of marijuana use among patients with HIV/AIDS followed in a public health care setting. (Prentiss D, Power R, Balmas G, Tzuang G, Israelski DM, 2004)
Short-term effects of cannabinoids in patients with HIV-1 infection: a randomized, placebo-controlled clinical trial. (Abrams DI, Hilton JF, Leiser RJ, Shade SB, Elbeik TA, Aweeka FT, Benowitz NL, Bredt BM, Kosel B, Aberg JA, Deeks SG, Mitchell TF, Mulligan K, Bacchetti P, McCune JM, Schambelan M, 2003)
The safety and pharmacokinetics of single-agent and combination therapy with megestrol acetate and dronabinol for the treatment of HIV wasting syndrome (Timpone JG, Wright DJ, Li N, Egorin MJ, Enama ME, Mayers J, Galetto G, 1997)
Dronabinol as a treatment for anorexia associated with weight loss in patients with AIDS (Beal JE, Olson R, Laubenstein L, Morales JO, Bellman P, Yangco B, Lefkowitz L, Plasse TF, Shepard KV, 1995)
Effect of dronabinol on nutritional status in HIV infection. (Struwe M, Kaempfer SH, Geiger CJ, Pavia AT, Plasse TF, Shepard KV, Ries K, Evans TG, 1993)
Dronabinol effects on weight in patients with HIV infection. (Gorter R, Seefried M, Volberding P, 1992)
Nabilone as effective therapy for intractable nausea and vomiting in AIDS. (Green ST, Nathwani D, Goldberg DJ, Kennedy DH, 1989)
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