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Daily Cannabis Use is Associated With Lower CNS Inflammation in People With HIV

Published online by Cambridge University Press:  15 July 2021

C. Wei-Ming Watson*
Department of Psychiatry, University of California, San Diego, USA San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, USA
Laura M. Campbell
Department of Psychiatry, University of California, San Diego, USA San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, USA
Ni Sun-Suslow
Department of Psychiatry, University of California, San Diego, USA
Suzi Hong
Department of Psychiatry, University of California, San Diego, USA Department of Family Medicine and Public Health, University of California, San Diego, USA
Anya Umlauf
Department of Psychiatry, University of California, San Diego, USA
Ronald J. Ellis
Department of Psychiatry, University of California, San Diego, USA Department of Neurosciences, University of California, San Diego, USA
Jennifer E. Iudicello
Department of Psychiatry, University of California, San Diego, USA
Scott Letendre
Department of Medicine, University of California, San Diego, USA
Thomas D. Marcotte
Department of Psychiatry, University of California, San Diego, USA
Robert K. Heaton
Department of Psychiatry, University of California, San Diego, USA
Erin E. Morgan
Department of Psychiatry, University of California, San Diego, USA
Igor Grant
Department of Psychiatry, University of California, San Diego, USA
*Correspondence and reprint requests to: Caitlin Wei-Ming Watson, M.S., HIV Neurobehavioral Research Program, 220 Dickinson Street, Suite B (8231), San Diego, CA92103, USA. E-mail:



Recent cannabis exposure has been associated with lower rates of neurocognitive impairment in people with HIV (PWH). Cannabis’s anti-inflammatory properties may underlie this relationship by reducing chronic neuroinflammation in PWH. This study examined relations between cannabis use and inflammatory biomarkers in cerebrospinal fluid (CSF) and plasma, and cognitive correlates of these biomarkers within a community-based sample of PWH.


263 individuals were categorized into four groups: HIV− non-cannabis users (n = 65), HIV+ non-cannabis users (n = 105), HIV+ moderate cannabis users (n = 62), and HIV+ daily cannabis users (n = 31). Differences in pro-inflammatory biomarkers (IL-6, MCP-1/CCL2, IP-10/CXCL10, sCD14, sTNFR-II, TNF-α) by study group were determined by Kruskal–Wallis tests. Multivariable linear regressions examined relationships between biomarkers and seven cognitive domains, adjusting for age, sex/gender, race, education, and current CD4 count.


HIV+ daily cannabis users showed lower MCP-1 and IP-10 levels in CSF compared to HIV+ non-cannabis users (p = .015; p = .039) and were similar to HIV− non-cannabis users. Plasma biomarkers showed no differences by cannabis use. Among PWH, lower CSF MCP-1 and lower CSF IP-10 were associated with better learning performance (all ps < .05).


Current daily cannabis use was associated with lower levels of pro-inflammatory chemokines implicated in HIV pathogenesis and these chemokines were linked to the cognitive domain of learning which is commonly impaired in PWH. Cannabinoid-related reductions of MCP-1 and IP-10, if confirmed, suggest a role for medicinal cannabis in the mitigation of persistent inflammation and cognitive impacts of HIV.

Regular Research
Copyright © INS. Published by Cambridge University Press, 2021

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