Abstract
Persistent inflammation occurs in people with HIV (PWH) and has many downstream adverse effects including myocardial infarction, neurocognitive impairment and death. Because the proportion of people with HIV who use cannabis is high and cannabis may be anti-inflammatory, it is important to characterize the impact of cannabis use on inflammation specifically in PWH. We performed a selective, non-exhaustive review of the literature on the effects of cannabis on inflammation in PWH. Research in this area suggests that cannabinoids are anti-inflammatory in the setting of HIV. Anti-inflammatory actions are mediated in many cases through effects on the endocannabinoid system (ECS) in the gut, and through stabilization of gut–blood barrier integrity. Cannabidiol may be particularly important as an anti-inflammatory cannabinoid. Cannabis may provide a beneficial intervention to reduce morbidity related to inflammation in PWH.
Highlights
This brief review will cover potential benefits of cannabis in reducing persistent inflammation and immune activation in virally suppressed people with HIV (PWH) and the possible resulting clinical benefits
In an animal model of HIV, macaques infected with simian immunodeficiency virus (SIV) showed increased markers of inflammation and immune activation in epithelial crypt cells; these markers were reduced after chronic THC administration [74]
In a large cohort of PWH, we recently reported that neurocognitive impairment (NCI) was less frequent in cannabis users than non-users, regardless of viral suppression [77]
Summary
This brief review will cover potential benefits of cannabis in reducing persistent inflammation and immune activation in virally suppressed people with HIV (PWH) and the possible resulting clinical benefits. The observations reviewed here suggest a program of future basic and clinical research to explore the potential benefits of cannabinoids for the treatment of inflammation-related disorders in PWH. Components of cannabis, present in varying degrees depending on the formulation, include the principal psychoactive component, tetrahydrocannabinol (THC), identified in the 1960s, cannabidiol (CBD), cannabinol (CBN), cannabigerol (CBG), cannabidivarin (CBDV), and other compounds, such as terpenes Each of these exerts unique pharmacological actions, with considerable evidence suggesting that the whole is greater than the sum of its parts (the “entourage” effect), reflecting therapeutic synergies between all of the phytocannabinoids and phytoterpenoids [12,13,14]. To what extent each of these components confers anti-inflammatory benefits is a current focus of research
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
