Cannabis Use and Reduced Risk of Insulin Resistance in HIV-HCV Infected Patients: A Longitudinal Analysis (ANRS CO13 HEPAVIH).

M P Carrieri,F Guitard,F Charlotte,S Breau,N Harchi,D Peyramond,E Chambon,J Durant,N Ouabdesselam,Y Baazia,C Lions,F Bendjaballah,P Trimoulet,O Cheminat,B Marchou,S Gillet,C Brochier,D Vittecoq,P Palmer,F Touam,C Pignon,S Caldato,O Zaegel,C Alavena,F Biron,Z Makhlouf,J Koffi,J Selves,P Geneau,C Majerholc,S Nafissa,For The Anrs Co Hepavih Study Group ,C Pallier,F Chouraqui,P Cacoub,M Rannou,T Lazure,C Partouche,D Garipuy,A Boibieux,H Mehawej,D Beniken,L Berroukeche,Geneviève Chêne ,Véronique Chambrin ,Laurent Cotte ,Olivier Lortholary ,Florence Nicot ,François Bailly ,Laurence Slama ,Anne Krivine ,Jean-Marc Duclos ,Caroline Solas ,Sandrine Couffin‐Cadiergues ,Fabien Zoulim ,Philippe Morlat ,Jean Daniel Lelièvre ,Catherine Tamalet ,Philippe Sogni ,Firouzé Bani‐Sadr ,Audrey Rodallec ,Marie-Josée Ferro-Collados ,Stéphanie Dominguez ,François Boué ,Philippe Bonnard ,Patrick Yéni ,Isabelle Poizot‐Martin ,P Girard ,Dominique Salmon‐Céron ,A Bicart‐See ,Marianne Ziol ,Philippe Bertheau ,François Raffi ,Hélène Fontaine ,Jacques Izopet ,Christine Katlama ,Anne Frosch ,Claudine Bolliot ,Frédéric Beuvon ,Valérie Paradis ,Brigitte Autran ,L Lacaze‐Buzy ,Homa Adle‐Biassette ,Claudine Duvivier ,Dominique Costagliola ,Bruno Spire ,Juliette Haudebourg ,Geneviève Dubost ,Éric Rosenthal ,Tristan Ferry ,R Fior ,Antoine Vilotitch ,Delphine Brosseau ,Amandine Ganon ,David Zucman ,Jean Michel Molina ,Ainhoa Simón ,Sylvie Radenne ,Marion Mora ,Marc Antoine Valantin ,Gwenaëlle Maradan ,M Saint-Paul ,Yann Quertainmont ,Claire Deback ,Thomas Perpoint ,Florence Ader ,A S Ritleng ,Élodie Pambrun ,Christian Combe ,Dominique Wendum ,Gilles Pialoux ,Anne Gervais ,Anne-Sophie Lascaux ,Thomas L’yavanc ,Valérie Thoirain ,Philippe Lack ,Paulette Bioulac‐Sage ,María Winnock ,Fabienne Marcellin ,Lawrence Serfaty ,Karl Barange ,P Callard ,Pauline Campa ,M Leonard Mole ,Patrick Miailhes ,Marc-Arthur Loko ,Hind Stitou ,J Polo Devoto ,Amélie Menard ,Laurence Dequae-Merchadou ,Slim Fourati ,Cécile Goujard ,Caroline Lascoux-Combe ,Benoı̂t Terris ,Laure Gibault ,Sandrine Reigadas ,Abbas Ali Imani Fooladi ,Antoine Champetier ,Karine Lacombe ,Patrizia Carrieri ,François Dabis ,Madona Azar ,Jean François Delfraissy ,Guy P Alexandre ,Olivier Bouchaud ,Marc Uzan ,Camélia Protopopescu ,Perrine Roux ,Éric Billaud ,A Joulié ,Catherine Lependeven ,Giovanna Melica ,Yves Benhamou ,Pascale Cervera ,Michaela Maynard ,Faroudy Boufassa ,Didier Néau ,Yves Lévy ,H Hüe ,Jamila K Adam ,A.m Roque ,Patrick M Honorè ,Valérie Martinez ,Michka Shoai‐Tehrani ,Sophie Métivier ,Frédéric J Tessier ,Christian Chidiac ,Mehdi Amiri ,Dominique Salmon ,Imad Kansau ,Fiona André ,Laurent Alric ,Dominique Bornarel ,Jean Delaune ,Laurence Meyer

doi:10.1093/cid/civ217

Abstract

Diabetes and insulin resistance (IR) is common in human immunodeficiency virus-hepatitis C virus (HIV-HCV)-coinfected patients, a population also concerned with elevated cannabis use. Cannabis has been associated with reduced IR risk in some population-based surveys. We determined whether cannabis use was consistently associated with reduced IR risk in HEPAVIH, a French nationwide cohort of HIV-HCV-coinfected patients. HEPAVIH medical and sociobehavioral data were collected (using annual self-administered questionnaires). We used 60 months of follow-up data for patients with at least 1 medical visit where IR (using homeostatic model assessment of insulin resistance [HOMA-IR]) and cannabis use were assessed. A mixed logistic regression model was used to evaluate the association between IR risk (HOMA-IR > 2.77) and cannabis use (occasional, regular, daily). Among the 703 patients included in the study (1287 visits), 323 (46%) had HOMA-IR > 2.77 for at least 1 follow-up visit and 319 (45%) reported cannabis use in the 6 months before the first available visit. Cannabis users (irrespective of frequency) were less likely to have HOMA-IR > 2.77 (odds ratio [95% confidence interval], 0.4 [.2-.5]) after adjustment for known correlates/confounders. Two sensitivity analyses with HOMA-IR values as a continuous variable and a cutoff value of 3.8 confirmed the association between reduced IR risk and cannabis use. Cannabis use is associated with a lower IR risk in HIV-HCV-coinfected patients. The benefits of cannabis-based pharmacotherapies for patients concerned with increased risk of IR and diabetes need to be evaluated in clinical research and practice.

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