Acquired Immunity Deficiency Syndrome (AIDS)

[palmspringsbum]

Why World AIDS Day Should Highlight the Need For Medical Cannabis

by Richard Cowan, OpEd, Windy City Times
December 5th, 2007


In the United States and throughout the Western world, patients with HIV and AIDS have been the driving forces behind the effort to legalize the therapeutic use of cannabis.

For over 20 years the HIV/AIDS community has been aware of pot’s medical utility—despite consistent denials from their elected officials regarding the plant’s efficacy. In recent years clinical studies have added credence to what were once only anecdotal claims.

For example, a study published this summer in the Journal of Acquired Immune Deficiency Syndromes reported, “Smoked marijuana … has a clear medical benefit in HIV-positive [ patients ] by increasing food intake and improving mood and objective and subjective sleep measures.”

The study appeared only months after investigators at the University of California’s Pain Clinical Research Center reported in the journal Neurology that inhaling cannabis significantly reduced HIV-associated neuropathy compared to placebo.

Previous studies point other benefits as well. For instance, clinical trial data published in the Annals of Internal Medicine in 2003 reported that cannabis use by HIV patients is associated with increased CD4/T-cell counts compared to non-users. A separate study published in JAIDS in 2005 found that HIV/AIDS patients who report using medical marijuana are 3.3 times more likely to adhere to their antiretroviral therapy regimens than non-cannabis users.

As a result, various surveys from North America now show that between 25 and 37 percent of HIV/AIDS patients report having used cannabis medically. Were cannabis to be formally legalized as a medicine, no doubt this percentage would grow much higher.

Unfortunately, despite the efforts of patients, most Americans with AIDS still do not have safe access to cannabis. This situation must change.

Tragically, the people who are supposed to be the beneficiaries of World AIDS Day ( W.A.D. ) cannot expect the world AIDS community to speak out for their need for cannabis. On the contrary, the United Nations, the very organization that is at the center of W.A.D. has other—much more powerful—subsidiaries, the International Narcotics Control Board and the United Nations Office on Drugs and Crime, which are committed to the total elimination of cannabis! Ironically, the “stigma” attached to the medical use of marijuana is being promoted by the same organizations that claim to be helping people with AIDS.

The UNAIDS.org Web site says, “The campaign for universal access to life saving drugs for HIV and AIDS, started originally by grassroots AIDS activists, is today a major focus of attention of UN agencies and others influential organizations at national and global levels.” Yet it is these very same organizations that spend millions to demonize cannabis and maintain the criminal laws that prohibit even the sickest patients from accessing its therapeutic benefits.

Unless and until the world AIDS community demands that the interests of the sick and dying take precedence over the so-called drug war, millions will continue to suffer needlessly at the hands of those claiming to help them.

[palmspringsbum]

Recreational drug use does not adversely affect CD4 cell counts

AIDSmap
Edwin J. Bernard, Wednesday, January 16, 2008

Use of the recreational drugs, cannabis, cocaine, poppers, or amphetamines, does not adversely affect the number or percentage of CD4 or CD8 cells in either HIV-positive or HIV-negative gay men, according to data from the Multicenter AIDS Cohort Study (MACS) published online on January 3rd in the journal Drug and Alcohol Dependence. However, the investigators did not measure the quality or function of these cells.

Animal and test tube studies have previously shown that recreational drugs such as cannabis (smoked as marijuana), cocaine, poppers, and amphetamines may adversely affect animal and human T cell responses.

Notably, cocaine given to HIV-infected mice greatly increased HIV levels and reduced CD4 cell counts to one ninth of the levels of the mice in the control group.

However, studies examining the impact of these recreational drugs on CD4 and CD8 T-cells in real life have reported inconsistent and conflicting findings, possibly due to confounding factors such as antiretroviral drug use, injecting drug use, and differences in the level and frequency of recreational drugs used over time.

Consequently, Dr Chun Chao of the University of California at Los Angeles, and her colleagues, sought to assess the association between cannabis, cocaine, poppers, and amphetamine use and CD4 and CD8 counts by examining survey data and medical records from HIV-positive and HIV-negative gay men and other men who have sex with men enrolled in the Multicenter AIDS Cohort Study (MACS).

In particular, they wanted to calculate the rate of CD4 and CD8 change as a function of drug use both at baseline and throughout the study period. In order to explore possible dose-response relationships, they looked specifically at frequency and duration of self-reported recreational drug use.

A total of 3236 HIV-negative men were included in the analysis (which included men enrolled from between April 1984 and April 2003). The average follow-up time for HIV-negative men was ten years.

A further 481 HIV-positive men were included in the analysis. These men were HIV-negative at MACS enrolment and acquired HIV before a cut-off date of December 31st1995, chosen to avoid any confounding effects of highly active antiretroviral therapy (HAART). The average follow-up time for HIV-positive men was five years.

Recreational drug use at baseline was high both for men who remained HIV-negative and those who became HIV-positive during the study.

Of the men who remained HIV-negative, 59% used cannabis, 27% used cocaine, 58% used poppers, and 16% used amphetamines at baseline.

Of the men who seroconverted during the study, 61% used cannabis, 30% used cocaine, 58% used poppers, and 17% used amphetamines at baseline.

Surprisingly, however, the investigators found that after controlling for smoking (which can raise CD4 cell counts) and other factors known to affect CD4 cell levels, the men who said they used any of the four drugs either at baseline, or any time during the study, had a (non-statistically significant) higher average CD4 cell count throughout the follow-up period, compared to those men who said they did not use any of the drugs.

Consequently, they write, “we did not find any clinically meaningful associations, adverse or otherwise, between use of marijuana, cocaine, poppers, or amphetamines and T cell counts and percentages in either HIV-uninfected or HIV-infected men.”

They add that they “also did not observe any threshold effect by frequency of use or duration of use (at least not with weekly or more frequent use or continuous use in the past year).”

They note that although their study found that the use of poppers was significantly associated with a lower CD4 cell count, “the size of the effect was tiny, even the strongest effect (for weekly or more frequent use) amounting to only a 4% reduction relative to [men] who did not use poppers.”

They also say that although other studies have suggested that cocaine use had an adverse effect on CD4 cell counts “this association was not observed in our study, even in those who used cocaine weekly or more frequently.”

The investigators also looked at the effect of tobacco smoking, and found that “tobacco smoking was associated with approximately 6% (p < 0.01) and 7% increase (p = 0.04) in mean CD4 cell count in HIV-uninfected and HIV-infected men.”

However, in their conclusion, the investigators concede that “although the circulating numbers of CD4 and CD8 T cells do not appear to be significantly affected by use of these substances, these findings do not preclude the possibility that substance use may adversely affect the functional properties of T cells.”

They also fail to point out that recreational drug use can affect sexual risk-taking; that use of poppers was significantly correlated with seroconversion during gay men’s unprotected sexual encounters; that amphetamine use can affect adherence to HAART; and that smoking may undermine the benefits of HAART.

<span class=postbold>Reference </span>
<small>Chao C, et al. Recreational drug use and T lymphocyte subpopulations in HIV-uninfected and HIV-infected men. Drug Alchol Depend doi:10.1016/j.drugalcdep.2007.11.010, 2008. </small>