No Link Between Marijuana Use and Changes in BMI, CD4 in HIV Patients

PHILADELPHIA, PA—Self-reported marijuana use among HIV-infected patients was not associated with changes in body mass index (BMI), CD4 T-cell counts, or detectable HIV RNA, a study reported at IDWeek 2014.

Cannabinoids affect immune modulation and HIV disease processes in cellular and animal models. Many HIV-infected persons use marijuana, but its effects in this population have not been evaluated, noted James Lee, MSc, form the School of Medicine, Vanderbilt University, Nashville, TN.

To address the effects of marijuana use in HIV patients, Dr. Lee and colleagues conducted an observational cohort study of 1,010 HIV-infected adults initiating their first antiretroviral therapy (ART) at the Vanderbilt Comprehensive Care Clinic.

At each visit, self-reported marijuana use in the last 7 days was evaluated, and associations between marijuana use, BMI, CD4 T-cell count, and HIV RNA levels (>400 copies), were assessed. To evaluate the impact of changing marijuana use on outcomes, logistic regression (detectable viral load) and linear regression (square-root CD4 count, BMI) were used. Random effects models were adjusted for age, gender, race, and self-reported ART compliance.

From 1,010 patients, 4,290 patient-visits were available from 2008 to 2011. 71.1% of the study population had undetectable viral loads. 811 patients reported no marijuana use, and 199 patients reported marijuana use on ≥1 days. In both the ‘No marijuana use' group and the ‘Marijuana use ≥1 visit' group, the majority were male (72.0% and 82.4%, respectively), Caucasian (49.8% and 52.3%, respectively), with an average age of 36.4 and 34.7, average BMI across visits of 27.2 and 25.8, and CD4 across visits of 487 and 477, respectively. 

No significant differences in CD4 count and BMI were reported across multiple models and measures of marijuana use (marijuana ever used, marijuana used in last 7 days, times marijuana used in last 7 days). Patients who reported using marijuana at any time during follow-up had increased odds of detectable viral load (OR=1.97, 95% CI 1.10–3.53), but the association was not present when examining visit-to-visit variation. 

“The absence of any association between BMI and marijuana use is of note,” said Dr. Lee, since “appetite stimulation and weight gain are often cited as indications for marijuana use”.