What HIV/AIDS is
HIV attacks CD4 immune cells. Antiretroviral therapy can suppress the virus and prevent progression to AIDS, but people may still experience appetite loss, weight loss, neuropathic pain, nausea and sleep problems. The cannabis studies in this register concern those symptoms and patterns of use, not treatment of HIV infection.
Cannabis research on HIV/AIDS
Haney and colleagues compared oral dronabinol and smoked cannabis in a small controlled laboratory study of HIV-positive cannabis users. Both were studied for caloric intake, mood and sleep. The narrow population, short setting and participants’ previous cannabis use limit how widely the results can be applied.
DeJesus and colleagues reviewed clinical records from people with HIV/AIDS who received dronabinol. Appetite and weight changes were reported, but the retrospective design had no randomised control group and cannot establish how much of the change was caused by dronabinol.
Phillips and colleagues systematically reviewed randomised trials for painful HIV-associated sensory neuropathy. Smoked cannabis was among the interventions with evidence for that specific pain outcome. The result applies to neuropathic pain studied in those trials, not to HIV infection itself or every form of HIV-related pain.
Milloy and colleagues reported an association between frequent cannabis use and lower viral load in a cohort of recently infected people who used injection drugs. This was observational. It does not show that cannabis suppresses HIV, and it cannot replace antiretroviral treatment evidence.
Compounds studied for HIV/AIDS
THC is the main cannabinoid represented in the appetite and neuropathy studies, through dronabinol and THC-containing cannabis.
CBD was not tested in the human HIV studies in this register. General anti-inflammatory research on CBD cannot be presented as HIV treatment evidence.
The register contains no HIV-specific human study of an individual terpene. Terpene descriptions should not be used to predict appetite, pain or antiviral effects.
Limits of the evidence for HIV/AIDS
The symptom studies used different designs, products and outcomes. A controlled laboratory study can measure short-term intake or sleep; a chart review records changes in routine care; a pain review combines defined trials; a cohort can identify associations. None of those designs demonstrates an antiviral treatment effect.
The register does not contain a controlled trial of cannabis for viral load, CD4 count, progression to AIDS or mortality. Antiretroviral outcomes and symptom outcomes must therefore remain separate.
Related conditions
- Neuropathic pain: cannabinoid trials for specific pain outcomes
- Palliative care: appetite, nausea and pain research
- Sleep problems: evidence on cannabinoids and sleep
Read next
Sources
1. Haney M, Gunderson EW, Rabkin J, et al. Dronabinol and marijuana in HIV-positive marijuana smokers: caloric intake, mood, and sleep. Journal of Acquired Immune Deficiency Syndromes. 2007;45(5):545-554. Study record
2. DeJesus E, Rodwick BM, Bowers D, Cohen CJ, Pearce D. Use of dronabinol improves appetite and reverses weight loss in HIV/AIDS-infected patients. Journal of the International Association of Physicians in AIDS Care. 2007;6(2):95-100. Study record
3. Phillips TJC, Cherry CL, Cox S, Marshall SJ, Rice ASC. Pharmacological treatment of painful HIV-associated sensory neuropathy: a systematic review and meta-analysis of randomised controlled trials. PLoS ONE. 2010;5(12):e14433. Study record
4. Milloy MJ, Marshall B, Kerr T, et al. High-intensity cannabis use associated with lower plasma HIV-1 RNA viral load among recently-infected people who use injection drugs. Drug and Alcohol Review. 2015;34(2):135-140. Study record
