Associations Between Cannabis Use and Inflammatory Biomarkers Among People with HIV

We explored whether self-reported current cannabis use is associated with inflammatory biomarkers among people with HIV (PWH), given high rates of cannabis use and chronic immune activation among PWH.

At seven Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) cohort sites, which integrate data on participant characteristics including demographic and clinical information, and substance use behaviors, we used linear regression to estimate the average difference in biomarkers associated with cannabis use, adjusted for demographic characteristics and sampling weights. Cannabis use was considered as Never, Former, or Current (past 3-month) use. Thirteen plasma biomarkers were measured once on or after 2010 among a subset of PWH on antiretroviral therapy with HIV viral suppression within CNICS. Cannabis use was assessed within 1 year prior to biomarker collection. Biomarkers were log-transformed and scaled by standard deviation to standardize estimates.

Among 532 PWH, the average age at biomarker collection date was 47 years, 84% were male, 61% non-White, 30% reported current cannabis use, 35% former use, and 35% never using cannabis. In adjusted linear regression, current cannabis use was associated with higher soluble CD14 (sCD14) levels (β = 0.35; 95% confidence interval [CI]: 0.09, 0.61). Former cannabis use was associated with lower C-reactive protein (CRP) (β = -0.25; 95% CI: -0.47, -0.04), although current use was not (β = -0.25; 95% CI: -0.51, 0.01) compared to never use.

Cannabis use may be related to lower CRP and elevated markers of microbial translocation (e.g., sCD14), which could have implications in increasing the risk of vascular events and should be investigated in a longitudinal setting.