Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 2017 04 25() doi 10.1093/cid/cix391
Marijuana use is prevalent among persons infected with HIV, but its long-term effects on HIV disease progression and comorbidities are unknown.
A prospective study of 558 HIV-infected men enrolled in the Multicenter AIDS Cohort Study between 1990-2010: 182 HIV seroconverters and 376 with viral suppression on combination antiretroviral therapy (ART). Associations between heavy marijuana use and HIV disease markers or white blood cell (WBC) count were examined using mixed-effects and linear regression models. Effects of marijuana use on cardiovascular (CV) events and other endpoints were estimated by Kaplan-Meier and logistic regression analyses.
The median baseline age of participants was 41, 66% were white, 79% had education > 12 years, and 20% reported heavy marijuana use at ≥ 50% of biannual visits during follow-up. Long-term heavy marijuana use showed no significant associations with viral load, CD4 counts, AIDS, cancer, or mortality in both cohorts, but was independently associated with increased CV events between ages 40-60 after adjusting for age, tobacco smoking, viral load, and traditional risk factors (odds ratio [OR], 2.5; 95% confidence interval [CI] 1.3, 5.1). Marijuana and tobacco use were each independently associated with higher WBC counts in adjusted models (P<0.01); in turn, the highest quartile of WBC counts (≥ 6500 cells/µL) was associated with increased CV events (OR 4.3; 95% CI, 1.5, 12.9). Conclusions.
Heavy marijuana use is a risk factor for CV disease in HIV-infected men ages 40-60, independent of tobacco smoking and traditional risk factors.