HIV specialists have been hearing about the medical use of marijuana even longer than researchers have been looking for an effective antiretroviral therapy. Initially touted as an appetite stimulant for HIV-related weight loss and a palliative therapy for easing the pain of death, cannabis has gained further use since the 90s, when the United States was in the middle of the “war on drugs” campaign.
The World Health Organization estimated that nearly 37 million people around the world live with HIV. More than 1.2 million of them are Americans. And one in eight HIV-positives does not even know that they are infected with the disease.
The world has committed to end the HIV/AIDS epidemic by 2030. Reaching this target within the Sustainable Development Goals is one of the main questions the UN is facing. And marijuana may potentially be the answer: some researchers believe that cannabinoids used in tandem with the existing antiretroviral drugs could open the door to the generation of new drug treatment for HIV/AIDS.
The human immunodeficiency virus (HIV) is a retrovirus that causes HIV infection and over time—acquired immunodeficiency virus (AIDS).
The virus spreads through certain body fluids that attack the immune system, specifically the CD4 cells, also known as T cells. HIV is gradually destroying these cells, and the body loses its ability to fight off infections and diseases.
HIV spreads through blood, semen, or vaginal fluids, usually through unprotected sexual contact, a blood transfusion from an infected person, from sharing needles when injecting drugs, or from mother to baby during birth.
HIV-positive people can even be unaware that they are infected. That is because early symptoms of HIV are often similar to other common illnesses such as the flu: people may experience headaches, diarrhea, loss of appetite, fatigue, fever, and nausea. As the disease advances, it makes a patient more susceptible to most infections, including fatal ones.
There is no cure for HIV. The good news is that with proper medication, HIV can be controlled, so a patient can live as long as a healthy person and not transmit HIV to others.
The medicines for treating HIV are called high active antiretroviral (ART/HAART) drugs. They suppress HIV, stop its progression, and prevent onward transmission of the virus.
There are more than 25 HIV drugs recommended by the Food and Drug Administration, and they are divided into six drug classes, each of which acts on different stages of the HIV life cycle. ART are mostly used in combinations of three or more drugs from more than one class. Such “combination therapy” helps prevent drug resistance. The choice of HIV medicines depends on a person's individual needs and takes into consideration many factors, including possible side effects, potential drug interactions, and other diseases that a patient may have.
These pharmaceuticals are strong and have a bunch of nasty side effects that make it difficult or even impossible for a patient to keep down drugs like lamivudine (3TC) or zidovudine (AZT). As a result of the antiretroviral therapy, about one-third of HIV/AIDS patients experience severe pain in nerve endings (polyneuropathies) and other common responses to HIV medication like vomiting, nausea, appetite loss, and wasting syndrome. At the same time, patients supplementing their therapy with marijuana are three times more likely to endure their antiretroviral treatment.
Marijuana was found to slow immune tissue damage in HIV-positive patients. In 2004, researchers at the Minneapolis Medical Research Foundation conducted an in vitro study and found that the synthetic cannabinoid WIN 55,212-2 could potentially inhibit HIV-1 expression in CD4(+) lymphocyte and microglial cell cultures. Three years later, another study demonstrated the involvement of CB2 receptors in the cannabinoid antiviral activity in microglial cells.
A 2011 study at The Louisiana State University Health Science New Orleans showed that THC had “immunomodulatory effects on cytokine production and lymphocyte phenotype, functions, and survival as well as cell-mediated immunity.” Chronic THC administration decreased early mortality from infection, and this was associated with attenuation of plasma and viral load in cerebrospinal fluid and retention of body mass.
Though the slowdown of the replication of HIV and marijuana administration requires further research, the existent findings open up fascinating possibilities for improved HIV therapies.
Many people with HIV experience loss of appetite. This symptom usually occurs along with vomiting, nausea, and diarrhea and may lead to wasting syndrome.
In 1999, the National Academy of Science's Institute of Medicine released a report where it was stated that marijuana could treat appetite loss, nausea, and vomiting. Marijuana was called a “promising treatment.”
Since then, there has been a growing body of evidence demonstrating the efficacy of cannabis in stimulating appetite. Patients with the disease require more calories to maintain their weight, and the drug helps restore appetite and promote weight gain.
A 2007 study on marijuana showed that smoking low doses of marijuana, particularly dronabinol (a synthetic form of THC), increased daily caloric intake and body weight in HIV-positive patients. Researchers also pointed to little evidence of discomfort and no impairment of cognitive performance.
HIV can cause debilitating pain, including muscle pain, nerve pain, and pain in joints.
Investigators at San Francisco General Hospital and the University of California's Pain Clinical Research Center who studied the long-term effects of smoking weed on patients with painful HIV-associated sensory neuropathy reported that smoking marijuana three times daily reduced pain in HIV-positive patients by 34 percent. They concluded that smoked weed could effectively relieve chronic neuropathic pain similarly to commonly prescribed oral drugs. Moreover, cannabis had fewer side effects compared to pharmaceuticals: opioids and other pills can reduce nerve pain, but they often cause drowsiness and confusion. And for some people, prescription drugs just do not work.
In 2008, researchers at the University of California in San Diego also found analgesic effects of cannabinoids. Their findings suggested that cannabinoid therapy might be an effective alternative for pain relief, mood problems, and certain physical disabilities in patients with HIV.
The American Academy of HIV Medicine, AIDS Action, National Association of People With AIDS, and many other top HIV/AIDS organizations support the idea of seriously ill HIV-positive patients having access to medical cannabis. Experts believe that marijuana, when appropriately prescribed and monitored, “can provide immeasurable benefits for the health and well-being” of HIV patients.