Marijuana Use and Cognitive Function in HIV-Infected People

Abstract

The effect of marijuana use on cognitive function is controversial. Although marijuana use is common in HIV-infected individuals for recreational and medicinal purposes, there have been no studies of the impact of marijuana on cognitive function in these subjects. Marijuana also has known immunologic effects, which increases the relevance in HIV-infected patients. We examined the interaction of HIV disease-stage and marijuana use in 282 subjects, stratified by disease stage and frequency of marijuana use. After controlling for the effects of depression, anxiety, and alcohol use, a significant interaction was observed on an overall measure of cognitive impairment. The effect of marijuana use was greatest in subjects with symptomatic HIV infection. Further inspection suggested that this effect was due primarily to performance on memory tasks. These data suggest that although there is minimal impact of marijuana on uninfected individuals or those at early stages of HIV infection, there is a synergistic effect of HIV and marijuana use in patients with advanced HIV disease. This is consistent with other data suggesting that the subtle effects of some conditions may become more manifest in the setting of immunocompromise.

Neuropsychological Complications of HIV Disease and Substances of Abuse

“…Neurological testing, intelligence, depression and anxiety were measured in 288 individuals (74 HIV seronegative, 127 HIVseropositive-asymptomatic and 87 HIV-seropositivesymptomatic). Marijuana use was dichotomized: those who reported having used less than once per month over the previous year were categorized as a no/minimal-use group with the remaining persons categorized as a frequent-use group [71] . Results revealed a significant interaction effect for HIV disease and marijuana use with respect to overall impairment score-the difference between the no/minimal-use group and frequent-use group was greatest among subjects with symptomatic HIV infection.…”

Safety Issues Concerning the Medical Use of Cannabis and Cannabinoids

“…A meta-analysis (78) of the residual neurocognitive effects of cannabis use reported decreases in the performance of memory tasks. A recent study (79) suggested that patients with advanced HIV/AIDS may be at risk for aggravated memory impairment due to cannabis use. The long-term effects of cannabis use on neurocognitive function may be due to a direct effect of cannabis use or may be due to confounding effects (80); further research is required to draw conclusions.…”

HIV-Related Neurocognitive Disorders and Drugs of Abuse: Mired in Confound, Surrounded by Risk

“…Cristiani et al [97] did find poorer performance on memory tasks for daily cannabis users with symptomatic HIV as compared with those with asymptomatic HIV and a sero-negative control group, and the amount of impairment appeared to increase across the stages of HIV disease. The authors concluded that cannabis affected users more as the HIV disease progressed; they postulated that subtle effects may become more significant in an immune-compromised person.…”