HIV - Cornell Medicine

Can cannabis help those suffering from HIV?
Weill Cornell Medicine intends to find out.

The prestigious institution was recently awarded a five-year, $11.6-million grant from the National Institute on Drug Abuse (NIDA) of the National Institutes of Health (NIH) to study the effects that cannabis, including marijuana and compounds derived from it, may have on the brains of those living with HIV.“We know that the virus may cause changes within the brain, but it’s not clear yet how the use of cannabis might interact with the infection,” said principal investigator Lishomwa Ndhlovu, a professor of immunology in medicine in the Division of Infectious Diseases at Weill Cornell Medicine, on cornell.edu.

Cannabis may exacerbate HIV’s effects on the brain, or it may protect against them; researchers don’t know yet, he said. “This support from NIDA will allow us to collect the data we need to explore this relationship.” The project is the newest component of NIDA’s SCORCH program, which seeks to investigate how substances that can lead to addiction may modify the effects of HIV in the brain, at the level of individual cells, the university noted. “This cannabis research, the second SCORCH project based at Weill Cornell Medicine, is being led by Ndhlovu; Michael Corley, assistant professor of immunology in medicine in the Division of Infectious Diseases; and Dionna Whitney Williams, assistant professor of molecular and comparative pathobiology at Johns Hopkins University School Medicine. An earlier project, begun in 2021, is mapping the effects of chronic opioid exposure in the brain.”

Benefits

Advancements in treatment have turned HIV into a chronic condition, according to the university. Although those with the virus can now live longer, HIV may still cause damage, including to the brain. Up to half of those living with HIV may experience declines in cognitive function, particularly in working memory and attention. “Studies have found that people living with HIV frequently use cannabis, recreationally or to treat symptoms related to HIV. As a potentially addictive substance, cannabis also alters the brain, and people with HIV may be at risk for cannabis use disorder,” according to Cornell. “Cannabis may also offer benefits for those living with HIV. It has an anti-inflammatory effect that researchers speculate could tamp down the chronic, harmful inflammation caused by the virus. Researchers think this inflammation contributes to the long-term health problems, including cognitive deficits, that people living with HIV may experience.”

“Findings from our lab and others demonstrate that inflammation can influence cognition in people living with HIV,” Williams said, “and we’re aiming to understand whether cannabis can mitigate those effects and how it does this on a molecular level.”

To examine the interaction between cannabis and HIV, the research team will focus on several brain regions, including the hippocampus, where new neurons form, in a process critical to learning and memory, the university explained. “Using brain tissue samples collected from human patients after death and from nonhuman animal models, they intend to look at gene activity and the mechanisms controlling it within individual cells.”

“It’s unclear how different types of brain cells react to cannabis in the context of HIV,” Corley said. “New single-cell technologies will allow us to map these changes at a resolution high enough to examine the effects on specific cell types.”

The information this project generates could, over the long term, boost efforts to better prevent and treat HIV-related cognitive deficits and cannabis use disorder, according to the researchers, the university made clear.

Relief From Symptoms
When it comes to helping those with HIV, cannabis appears to be promising.

NIH's National Library of Medicine pointed out that “Although no comprehensive surveys have been conducted on medical marijuana users in the United States, small-scale polls indicate that most are seeking relief from symptoms of AIDS. For example, each of the three California cannabis buyers' clubs — organizations that provide marijuana to patients — visited by the IOM team reported that more than 60% of their members requested the drug for AIDS treatment.”

Age is often cited as the reason why such a large proportion of medical marijuana users in the United States are people with AIDS (this is not the case elsewhere; in Great Britain, for example, multiple sclerosis appears to predominate among medical marijuana users).

Because HIV has disproportionately infected members of a generation that grew up experimenting with marijuana, so the theory goes, AIDS patients tend to be comparatively willing to use it as a medicine. By contrast, cancer patients, who are on average older and thus less likely to have tried marijuana, are far less inclined to seek it out. If this reasoning is correct, increasing numbers of cancer patients should turn to medical marijuana as the baby boom generation ages.

“Because HIV attacks the immune system, it wreaks havoc throughout the body,” NIH reported. “Besides providing a foothold for opportunistic infection and cancer, the virus also triggers a potentially lethal wasting syndrome, painful nerve damage, and dementia. Finally, in addition to the physical discomforts inflicted by HIV, many people with AIDS also struggle with depression and anxiety. Marijuana, some patients say, eases all of these problems and more.”