Review showed combining the use of cannabis with HAART made patients withstand antiretroviral medications for significantly longer periods of time

Even though cannabis and cannabinoid-derived pharmaceuticals are frequently used by HIV/AIDS patients, several studies show that something interesting happens when cannabis is consumed.

What is HIV and how is it manifested?

Human immunodeficiency virus (HIV), as the name implies, harms the immune system. HIV produces this effect by killing specific white blood cells (CD4 T cells), otherwise known as T-helper cells), which are in charge of destroying pathogens.

Infections are caused by either bacteria or viruses, and CD4 T cells react to those threats in two distinct ways:

by releasing chemicals that inform other cells of the immune system to the site of the infection; and

by releasing chemicals that cause other white blood cells to multiply.

These newly created white blood cells create markers called antibodies, which can identify the same foreign invader throughout the body. Antibodies attach to bacteria and viruses, but also to infected cells, marking them for destruction by the immune system.

HIV also multiplies by entering healthy CD4 T cells, and the quantity of HIV in the body directly determines how rapidly it can enter and kill other CD4 T cells. The amount of HIV in one’s blood is called the viral load.

If left untreated, HIV spreads to such an extent that the immune function is so diminished that the body cannot protect itself anymore, leading to various dangerous infections. When these infections occur as a result of a weakened immune system, they are called “ opportunistic infections.” Examples include pneumonia, cancers, tuberculosis, chronic diarrhea and inflammation-based conditions such as meningitis and encephalitis.

When HIV weakens the immune system so much that opportunistic infections start to occur, it is then considered that a patient now has acquired immunodeficiency syndrome (AIDS).

How classical pharmaceuticals fight HIV

Drugs used for the treatment of HIV and AIDS are called antiretroviral medications, and there are several different classes of these drugs:

fusion/entry inhibitors—they prevent, or more precisely, slow down HIV from entering healthy cells;

reverse transcriptase inhibitors—they prevent the RNA—which functions as an information carrier or messenger—of the virus to be reverse transcribed into DNA;

protease inhibitors—they prevent the protease enzyme from producing mature virions of the virus;

integrase inhibitors—they prevent the retroviral integrase (IN) enzyme from integrating the RNA of HIV to the DNA of the infected immune cell.

These medications are combined in what’s known as HAART, or highly active antiretroviral therapy.

Even though these pharmaceuticals slow down the progression and lessen the quantity of the virus in a patient’s body, many sufferers experience severe pain from antiretroviral therapy. Other side effects include nausea and vomiting, loss of appetite and weight, chronic exhaustion, physical weakness and cachexia (wasting syndrome). HIV patients frequently combat anxiety and depression, and the intensity of these side effects often cause patients to stop their therapy in a bid to experience relief.

Cannabis as a palliative aid for HIV patients

As most people are probably already aware, medical cannabis is used to fight many of the aformentioned symptoms, including pain, nausea and vomiting, lack of appetite, disorders of the gastrointestinal tract, and also anxiety and depression. The results of a 252-patient review showed that combining the use of cannabis with HAART made patients withstand antiretroviral medications for significantly longer periods of time compared to patients who weren’t using cannabis.

Another survey published in the Journal of Acquired Immune Deficiency Syndrome showed that HIV patients who used cannabis in combination with their regular treatment experienced significant relief from anxiety, depression and pain, as well as had improved appetite. They also reported an overall increase in pleasure.

What’s also very important to understand is that palliative care isn’t the only way cannabis influences the way a body reacts to HIV.

Before getting into all of that, however, first it’s necessary to take a step back and analyze how cannabis impacts an organism.

All vertebrate species on the planet have an endocannabinoid system (ECS) embedded in their biochemical structure. This system consists of endocannabinoid receptors stationed on the membranes of many different cell types, which are present in all important parts of the body, including the brain and spinal cord, vital and reproductive organs, gastrointestinal tract, muscles, connective tissues and so forth.

The second part of the ECS are endocannabinoids, the internal chemical compounds that entice these cellular receptors, causing many different reactions within each individual cell.

The function of the ECS

This ancient mammalian physiological system is in charge of maintaining homeostasis on a cellular level. Homeostasis is a posh term used to describe a state of balance between the separate, but interconnected, systems that make up an organism. Cannabinoids from the cannabis plant trigger the endocannabinoid receptors of the cells in the same way as endocannabinoids, and this additional enticing of the receptors is beneficial in many ways.

There are many different cell types in the human body. Depending on what type of cell it is, but also the type of condition a person is struggling with, these factors determine how a specific cell will react to cannabinoids.

The ECS is extremely complex and very adaptive, and because of these characteristics, cannabis is regarded as beneficial for many different conditions and disorders.

Cannabis as medicine against HIV

Besides offering palliative aid for numerous side effects that accompany HAART therapy, cannabis also directly influences how a human body reacts to HIV. Even though scientific data is still somewhat scarce on this topic, several studies, including the following, confirm that cannabis directly acts on the cells of the immune system affected by HIV.

2016: 55 HIV-positive patients, who reported their personal use of cannabis, were divided into three categories: non-users, light users and moderate to heavy users. Both light and moderate/heavy use patients had a lower viral load, and a higher number of CD4 T immune cells, compared to patients who didn’t consume cannabis.

2003: This study from the University of California San Francisco included 62 HIV patients who were randomly separated into three groups. Twenty patients received an oral placebo, 20 patients got cannabis in the form of a joint and 22 received dronabinol (U.S. Food and Drug Administration-approved medication containing synthetically created and isolated THC, branded and sold as Marinol or Syndros). The study lasted for 25 days, and after comparing results, researchers found there was a 20 percent increase of CD4 T cells in both real-cannabis and dronabinol groups. The team behind this study also found that the number of CD8 T-cells rose 20 percent in the real-cannabis group, and 10 percent in patients who were given dronabinol. CD8 T cells of the immune system could be considered as the secondary target for the HIV virus, right after CD4 T cells.

2011: This study focused on the SIV virus (simian deficiency virus), which is a disease that affects primates, and is very similar to HIV. Researchers frequently analyze SIV to draw conclusions about HIV. Scientists observed numerous positive effects on the subjects upon administering THC, including slowing down the progression of the disease, lower viral loads and lessened inflammation via immunosuppression. Combined, these factors significantly reduced the mortality rate.

2007: This research was performed on microglia cell cultures (microglia are a type of different immune cells found in the brain and spinal cord), with a synthetic compound very similar to THC. This study showed that by introducing this compound, which affected these microglia cells via both CB1 and CB2 cannabinoid receptors, the replication of the HIV virus was suppressed. What’s also very interesting is that microglia cells “create” these cannabinoid receptors when they need to be affected by cannabinoids/endocannabinoids (on demand), in a process known as reverse transcription-polymerase chain reaction.

Biggest cannabis/HIV study is yet to come

University of Florida received a US$3.2 million grant from the National Institute on Drug Abuse in 2017 to conduct a five-year study on the effects of cannabis on HIV. It will be the biggest and most comprehensive research on this topic to date, and will involve 400 HIV patients from Florida.

The head researcher, Dr. Robert Cook, shared his views on the goals of the study: “I’ve seen some very interesting data that looked at just how much of the virus is in people’s blood before they were treated with antiretrovirals. The research showed that those who used marijuana had a lower amount of the virus in their blood compared to those who didn’t use marijuana. That’s a good thing if there is a lower amount of the virus. But I haven’t seen any clinical trials looking at the direct effects of THC on the virus. We also don’t have a lot research comparing THC alone versus THC and CBD on people with HIV.” This study is expected to provide the much-needed insight for HIV-infected patients.

So to sum things up, cannabis greatly diminishes the side effects of HAART therapy, and it also influences the cells of the endocannabinoid system to directly fight the virus.

Greencamp.com is an educational website dedicated to shedding light on many unexplored sides of medical and recreational cannabis. Aside from informing people of safe cannabis use, Greencamp also provides technology for finding optimal cannabis treatment.

Want to keep up to date on what’s happening in the world of cannabis? Subscribe to the Cannabis Post newsletter for weekly insights into the industry, what insiders will be talking about and content from across the Postmedia Network.