The human immunodeficiency virus (HIV) is a retrovirus responsible for the acquired immunodeficiency syndrome (AIDS)

[1], which is a weakened and vulnerable state of the immune system[2]. Without any treatment, the life expectancy of a person suffering from HIV is from 9 to 11 years[3].  AIDS is the most advanced form of HIV infection. At this stage, the immune system is very weak or destroyed and patients suffer from opportunistic illnesses that put their lives at risk[4].

In 2017, more than 36.9 million of people worldwide were reported to be infected, of which 1.8 million people were recently infected[5].  The initial conditions that signal the presence of AIDS are: pneumonia and pneumocystis, cachexia, Oesophageal candidiasis and recurrent respiratory tract infections[6].

Opportunistic infections can be caused by viruses, bacteria, parasites and fungi, which are normally controlled by the immune system[7].  The most common systemic symptoms are sweating, fever, swollen lymph nodes, weakness, shivering, involuntary weight loss[8], [9], [10] and diarrhoea[11]. They may also be affected by various neurologic and psychological manifestations[12].

Medical cannabis and AIDS

Cannabinoids are the chemical substances found in the cannabis plant. These molecules have excellent therapeutic properties, because they act on the human endocannabinoid system, which is composed by endocannabinoid ligands and endogenous receptors. When the cannabinoids and endocannabinoids bind to the receptors, this interaction of elements causes changes in the cells. This activation is very important for the body to function with normality.

These receptors are found on the membranes of the body’s cells. Two types of receptors can be found: CB1 receptors, located mainly on the central nervous system but also in small quantities in the peripheral nervous system, and CB2 receptors, located in different parts of the immune system.

A team of researchers studied the use of cannabis to relieve the variety of side-effects provoked by the antiretroviral treatment in HIV patients. This research reported that cannabis improved appetite (97%), muscle pain (94%), nauseas (93%), nerve pain (90%), anxiety (93%), paraesthesia (85%) and depression (86%)[13]. In addition, there already exist many articles that explain the role that cannabinoids play in fighting depression, relieving chronic pain and reduction of nauseas[14] and vomiting (provoked by the antiretroviral treatment).

Another study compared patients with two types of treatment: cannabis treatment and another kind of synthetic THC, dronabinol. In conclusion, both groups saw a similar increasement in the appetite and the number of meals taken, but only medical cannabis restored sleep[15].

Medical cannabis to reduce the progression of HIV and AIDS

The lymphoid tissue associated with the intestine is an important site for the propagation of HIV. A new study demonstrated that chronic administration of Δ9-tetrahydrocannabinol (THC) resulted in a generalised attenuation of viral load and tissue inflammation in animals (monkeys) infected with the immunodeficiency virus. The mechanism in question was caused by a genetic change in the immune cells of the intestine, especially in the genes that control the morphogenesis, metabolic processes, survival, proliferation and programmed cell death[16].

HIV needs white blood cells to be active in order to spread, but at an advanced stage of infection, the virus can even insert itself in those white blood cells that are at rest and activate them. This causes an even greater propagation of the virus. Recently, researchers have made a very promising discovery: CB2 receptor agonist reduces the mechanism of HIV infection[17]. However, several studies are needed in order to understand better the potential of medical cannabis.

Did you like the post? Give us some feedback! This post has been done based on existent research to the date of publication of the article. Due to the increase in studies based on medical cannabis, the information provided can vary over time and we’ll keep informing in further writings.

[1] Weiss RA. How does HIV cause AIDS? Science. 1993;260:1273–1278. PMID: 8493571

[2] Douek, D.C., Roederer, M., Koup, R.A. 2009. Emerging concepts in the immunopathogenesis of AIDS. Annu. Rev. Med. 60:471-484.

[3] UNAIDS, WHO (december 2007) 2007 AIDS epidemic update

[4] About HIV/AISD¨. December 6, 2015. Retrieved February 11, 2016.

[5] Fact sheet- Latest statistics on the status in the AIDS epidemic. UNAIDS

[6] Mandell, Bennett, and Dolan (2010). Chapter 118

[7] Holmes CB, Losina E, Walensky RP, Yazdanpanah Y, Freedberg K (2003) Review of human immunodeficiency virus type 1-related opportunistic infections in Sub-Saharan Africa. Clin Infect Dis, 36, 652–662

[8]Del Rio C, Curran JW. Epidemiology and prevention of acquired immunodeficiency syndrome and human immunodeficiency virus infection. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 118.

[9] Piot P. Human immunodeficiency virus infection and acquired immunodeficiency syndrome: A global overview. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadlelphia, Pa: Saunders Elsevier; 2007:chap 407.

[10] Sterling TR, Chaisson RE. General clinical manifestations of human immunodeficiency virus infection (including the acute retroviral syndrome and oral, cutaneous, renal, ocular, metabolic, and cardiac diseases). In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 121.

[11] Sestak K (2005) Chronic diarrhea and AIDS: insights into studies with non-human primates. Curr HIV Res 3: 199–205. PMID 16022653

[12] Murray ED, Buttner N, Price BH (2012). “Depression and Psychosis in Neurological Practice”. In Bradley WG, Daroff RB, Fenichel GM, Jankovic J. Bradley’s Neurology in Clinical Practice: Expert Consult – Online and Print, 6e (Bradley, Neurology in Clinical Practice e-dition 2v Set)1 (6th ed.). Philadelphia: Elsevier/Saunders. p. 101

[13] Woolridge E, Barton S, Samuel J, Osorio J, Dougherty A, and Holdcroft A (2005) Cannabis use in HIV for pain and other medical symptoms. J Pain Symptom Manage 29:358–367

[14] De Jong BC, Prentiss D, McFarland W, Machekano R, Israelski DM. Marijuana use and its association with adherence to antiretroviral therapy among HIV-infected persons with moderate to severe nausea. J Acquir Immune Defic Syndr. 2005;38:43–46

[15] Haney M, Gunderson EW, Rabkin J, Hart CL, Vosburg SK, Comer SD, Foltin RW. Dronabinol and marijuana in HIV-positive marijuana smokers: Caloric intake, mood, and sleep. JAIDS 2007;45:545– 554

[16] Molina PE, Amedee AM, LeCapitaine NJ, Zabaleta J, Mohan M, Winsauer PJ, Stouwe CV, McGoey RR, Auten MW, LaMotte L, Chandra LC, Birke LL (2014) Modulation of gut-specific mechanisms by chronic D9-tetrahydrocannabinol administration in male rhesus macaques infected with simian immunodeficiency virus: a systems biology analysis. AIDS Res Hum Retrovir 30:567–578

[17] Costantino CM, Gupta A, Yewdall AW, Dale BM, Devi LA, Chen BK (2012) Cannabinoid receptor 2-mediated attenuation of CXCR4-tropic HIV infection in primary CD4+ T cells. PLoS One 7:e33961