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    • br Introduction Over one million people are currently living

    2021-09-17


    Introduction Over one million people are currently living with HIV in the United States (CDC, 2016). Through advances in HIV medications, the use of antiretroviral therapy has led to people living longer with HIV (Palella et al., 2006). In attempts to mitigate the effects of the psychological and physiological symptoms posed by HIV, some people living with HIV (PLWH) are using marijuana for symptom palliation (Prentiss et al., 2004). Although marijuana may offer some relief to PLWH for a variety of symptoms, marijuana usage also has potentially deleterious immunomodulatory effects, leaving individuals more susceptible to infections (Cabral and Pettit, 1998; Klein et al., 1998; Keen et al., 2014; Keen and Turner, 2015). Therefore, PLWH who use marijuana may be at increased risk of infection as their immune system is already compromised. Cross-sectional studies in PLWH examining the relationship between marijuana use and cluster of differentiation 4 (CD4+) or cluster of differentiation 8 (CD8+) T lymphocyte counts have shown inconsistent results (Whitfield et al., 1997; Furler et al., 2004; Abrams et al., 2003; Kuo et al., 2004; Chang et al., 2001; Chao et al., 2008; Bonn-Miller et al., 2014; Kelly et al., 2016; Okafor et al., 2016). However, longitudinal research suggest that marijuana use frequency is not deleterious or associated with CD4 + T Meropenem trihydrate in a sample of HIV and Hepatitis C co-infected patients (Marcellin et al., 2017). In PLWH, the CD4+ and CD8 + T lymphocytes counts are reduced due to the HIV virus utilizing the these T lymphocytes to replicate the virus and ultimately destroy infected cells. As a result, the ability to fight infection is reduced because of a reduced number of CD4+ and CD8 + T lymphocytes. The addition of a substance like tetrahydrocannabinol (THC) that further suppresses the activity of immune cells, raises the concern that further inhibition of function in a patient with a diminished cell population would significantly increase the risk for infections. On the other hand, THC inhibiting the same immune cells (i.e. natural killer cells and cytokines) that aid the HIV virus in infecting other cells that are recruited may save such T lymphocytes from further infection (Molina et al., 2011). The use of marijuana for palliation in PLWH for neurologic symptoms is on the rise (Purohit et al;, 2014), however, there is a dearth of literature that examines the difference in HIV-related immune function among recent users and non-users. Given the immune system dysregulation, paired with the deleterious influence of HIV on immune function may leave PLWH more susceptible to disease, it is important to determine the potential risk/benefit of marijuana in this group. This is especially imperative to examine in African Americans/Blacks (Blacks), who are disproportionately affected by HIV (CDC, 2016). The purpose of the current study was to examine the differences in CD4+ and CD8+ counts between Black PLWH who urine drug test positive for THC compared to Black PLWH who test negative for THC. Based on previous research, we hypothesized that PLWH who urine test positive for THC will have significantly lower CD4+ and CD8+ counts when compared to their negative counterparts.
    Material and methods
    Results
    Discussion The current study sought to examine the differences in CD4+ and CD8+ counts between those who tested positive for THC and patients who tested negative for THC in a sample of heterosexual Black PLWH. Both THC negative and THC positive PLWH had CD4+ lymphocyte cell counts above 500 cells/mm3, which suggests the majority of the current sample were in relative good health regarding their HIV progression. Though unadjusted comparisons did not yield statistically significant results, those who tested positive for THC had significantly higher CD4+ and CD8+ cell counts in the presence of demographic, physiological, and HIV-related covariates. The current findings are in line with previous research, reporting daily marijuana users have higher CD4+ cell counts and lower viral load than their non-using and infrequent using counterparts (D’Souza et al., 2012; Milloy et al., 2015). This finding also supports results reported in community based samples of HIV positive marijuana users with higher CD4+ cell counts than their non-using counterparts in Los Angeles (Thames et al., 2016), Houston (Mayben et al., 2007), and Australia (Fogarty et al., 2007).