Can CBD help with HIV, and if so, how? Are there any interactions between CBD and HIV medications that should be a cause of concern?
More and more scientific studies reveal the antiviral potential of cannabis, highlighting CBD as a potential treatment option for the symptoms of HIV, AIDS, and other autoimmunity diseases.
CBD is widely known to treat fatigue, pain, vomiting, and nausea, which are common side effects of HIV and AIDS. The compounds in cannabis have also been found to alter immune responses in patients with HIV, indicating that cannabis may help slow the progression of HIV.
What is HIV?
Human Immunodeficiency Virus (HIV) is a virus that spreads in the body through body fluids attacking the CD4 cells of the immune system.
CD4 cells, also called CD4+ T cells, are white blood cells that fight infection. Destruction of CD4+ T cells affects the effectiveness of the body in combating infections and diseases.
As HIV infection progresses, the number of these cells declines. Typically, the CD4 cell count increases when the HIV virus is constrained with effective HIV medication.
The average range for CD4 T cells is 500 to 1,500. When the CD4 T cell count drops below 200, HIV progresses to Acquired Immunodeficiency Syndrome (AIDS). With AIDS, the body battles threats that can be fatal even from infections and diseases that a healthy individual can handle.
CD4 T cell count indicates how severely the immune system has been affected and the extent to which the body can combat infections.
By reducing the quantity of HIV in the body, HIV medicines also reduce the risk of HIV transmission.
Antiretroviral therapy (ART) is the utilization of HIV medicines to alleviate HIV infection, and its primary goal is to reduce the viral load while increasing CD4 count.
Having reduced HIV in the body gives the immune system an opportunity to recover. Although there is still some HIV left in the body, the immune system is strong enough to combat infections and certain HIV-related cancers.
Doctors recommend ART for everyone who has HIV. ART cannot eliminate HIV, but it can reduce the risk of HIV transmission. People on ART take a combination of HIV medicines every day to help them live longer, healthier lives.
ART’s primary goal is to reduce a person’s viral load to an undetectable level.
The viral load refers to the quantity of virus in the blood of an HIV patient. An imperceptible viral load means the level of HIV in the blood is too low to be detected by a viral load test.
HIV-positive people who maintain an undetectable viral load would not be able to transmit HIV to their HIV-negative partner through sex.
Quality of Life
HIV disease is among the most distressing of diseases, having numerous and life-changing effects on the patients. Thus, the assessment of QOL is essential.
Research defines QOL as an overall sense of well-being, including happiness and satisfaction with life as a whole.
The World Health Organization (WHO) describes QOL as an “individuals’ perceptions of their position in life in the context of the culture and value systems in which they live and in connection to their goals, standards, expectations, and concerns.”
Studies determined relationships among various psychosocial and spiritual factors, indications, and physical health. Still, more research is needed to document their potential impacts on immune function, health condition, disease progression, and QOL among persons with HIV disease.
The role of consultation-liaison psychiatry is also crucial in the diagnosis and treatment of HIV and AIDS. Stress management interventions for HIV-infected persons are a promising approach to facilitate positive adjustment in patients who have HIV/AIDS.
HIV/AIDS Affect the Endocannabinoid System
Medical marijuana, often referred to as medical cannabis, is a term for extracts derived from the Cannabis sativa plant that are used to remedy severe and chronic symptoms.
The endocannabinoid system (ECS) holds crucial information on HIV and AIDS management.
Cannabinoids bind to cannabinoid receptor sites to promote the proper physiological function of the muscular system, immune system, and nervous system. The cannabinoids stimulate the CB1 and CB2 receptors located within the body’s endocannabinoid system (ECS) to successfully reinstate stable bodily functions.
CBD and Antiretroviral Drugs Interactions
According to several studies, cannabidiol (CBD) provides pain relief chiefly by inhibiting the neuronal transmission in the pain pathways.
Although research is inadequate given the small sample sizes and short duration of the study, the evidence supports the safety and efficacy of short-term, low-dose vaporization and oral delivery of medical cannabis for the treatment of neuropathic pain.
CBD can stimulate direct lipogenic (fat-producing) action that improves and changes fat distribution in patients. The lipid mediators stimulate CB1 and CB2 receptors to carry out central nervous system (CNS) regulation, inflammation control, and pain management.
Research shows that the attenuation of these mediators and receptors in HIV patients inhibits homeostasis. The resulting imbalance inevitably results in various HIV and AIDS symptoms, including lethargy, loss of appetite, weight loss, and other side effects caused by a weakened immune system.
However, cannabis smoke and cannabinoids do not adversely affect the immune status of HIV patients, as studies suggest.
Also, the studies did not provide sufficient evidence to support or refute a statistical correlation between cannabis use or dronabinol use and adverse effects on immune status in HIV-positive individuals.
Marinol (dronabinol), a drug approved by the United States Food and Drug Administration, is a human-made form of cannabis that has been marketed as a safe alternative to medical marijuana. Its active ingredient is synthetic tetrahydrocannabinol (THC), a compound that produces the psychoactive effects of marijuana.
Doctors prescribe dronabinol to help combat the side effects of cancer treatment, such as vomiting, nausea, loss of appetite, and pain.
Only one study has examined the effects of cannabinoids on the pharmacokinetics of antiretrovirals. Researchers in the study concluded that the use of marijuana or dronabinol is unlikely to impact antiretroviral efficacy.
Still, it is essential to note that there were significant shortcomings in the experimental design of the studies, which could have contributed to the absence of adverse effects being observed in HIV patients who used cannabis or cannabinoids. The shortcomings include short study durations, a small number of study participants, and poorly-defined levels of cannabinoid exposure.
In a review, researchers proposed to conduct a pilot randomized clinical trial to examine the safety and tolerability of cannabis oils containing THC and CBD that HIV patients consume orally.
HIV and Pregnancy
Drugs used to treat HIV infection may induce adverse side effects. However, HIV-positive pregnant women not taking medication dramatically increases the chances of passing the virus to the fetus.
The U.S. Department of Health and Human Services lists down the antiretroviral agents that pregnant women with HIV may use. The agency also categorized these drugs, whether they are safe or toxic.
On their AidsInfo website, the National Institutes of Health (NIH) emphasizes the following key points:
- The NIH advises all pregnant women with HIV to take HIV medicines to protect their health, as well as avoid mother-to-child transmission of HIV.
- Generally, HIV medicines do not increase the risk of congenital disabilities. Most HIV medicines are safe to use during pregnancy.
- Pregnant women with HIV can use the same HIV regimens recommended for non-pregnant adults unless the risk of any known side effects to a pregnant woman or her baby outweighs the benefits of a regimen.
- The NIH encourages all pregnant women with HIV to start taking HIV medicines immediately.
- For women already taking HIV medicines before they became pregnant, the agency recommends the maintenance of those HIV medicines throughout their pregnancies.
- The NIH also advises women with high or unknown viral loads near the time of delivery to schedule a cesarean or C-section delivery to prevent mother-to-child transmission.
CBD is Not Recommended During Pregnancy
The U.S. Food and Drug Administration (FDA) wants the public to be aware that there may be great risks to using cannabis products, including those containing CBD, for women who are pregnant or breastfeeding.
There are several potential adverse health effects from using marijuana and other products containing THC during pregnancy and while breastfeeding.
The U.S. Surgeon General recently cautioned consumers that marijuana use during pregnancy may affect fetal brain development. THC has the capacity to enter the fetal brain from the mother’s bloodstream.
The Surgeon General VADM Jerome said, “I am emphasizing the importance of protecting our Nation from the health risks of marijuana use in adolescence and during pregnancy. Recent increases in access to marijuana and in its potency, along with misperceptions of safety of marijuana, endanger our most precious resource, our nation’s youth.”
Even if CBD helps alleviate some of the adverse effects of HIV drugs, experts do not recommend its use during pregnancy and breastfeeding.
A growing number of states, except CBD oil-only states, or states with endless lists of conditions, explicitly include HIV or AIDS as a qualifying condition for medical marijuana use.
As of 2019, those 29 states include Alaska, California, Colorado, Florida, Hawaii, Nevada, New Jersey, New York, Ohio, South Carolina, Vermont, and Washington.
The consumption of CBD supplements and the use of CBD oil make HIV more manageable and suppress symptoms, from anxiety and fatigue to lack of concentration, insomnia, chronic pain, and skin infections.
The most damaging effect of HIV is the weakening of the immune system. Prescribed drugs are crucial to help in the healing process, but a support system is necessary to manage the side effects of these pharmaceuticals, as well as secondary infections.
Consumption of CBD HIV supplements works to help HIV medications take effect. The patient can relax and acquire an improved appetite, which is advantageous in the recovery process.
There are nearly 8,000 clinical studies on HIV and HIV-related disorders listed on ClinicalTrials.gov, an online resource provided and maintained by the U.S. National Library of Medicine.
Although there has not been any proven cure for HIV or AIDS, research is still ongoing, with many supplements and medications emerging to make treatment bearable and the patient’s life comfortable.
FREQUENTLY ASKED QUESTIONS ABOUT PREGNANCY AND HIV
I am pregnant or thinking about having a baby. Should I be tested for HIV?
If you are thinking of having a child or you are already pregnant, it is important that you get tested for HIV. There are many pregnant women who are HIV positive and do not know about it.
If you are HIV positive and you are aware of this infection, then there are very good prevention strategies available to decrease the risk of your child becoming infected. Without any kind of prevention strategy, the risk of mother-to-child transmission is about 25%. However, if prevention strategies begin in sufficient time, this risk can be reduced to 1%.
I am/we are HIV positive. Is it possible to conceive safely?
There is information available to help infected partners or couples take protective measures to help reduce the risk of transmitting HIV infection to their partners and babies.
I am/my female partner is HIV positive. Is pregnancy harmful to the health of women with HIV infection?
Studies indicate that pregnancy does not harm the health of women with HIV infection or increase the chance of women developing HIV related illnesses.
I am HIV positive and pregnant. Will my baby be infected as well?
Most babies born to HIV-positive mothers will not get HIV. But some will. A baby can get HIV from its mother during pregnancy (before birth), during delivery (the most common way babies get infected), and through breast feeding.
There is approximately a one-in-four chance of mother-to-child transmission of HIV infection without any treatment. But, treatments and interventions exist that have been shown to significantly reduce the risk of infection to babies.
During pregnancy and delivery, you can take antiretrovial drugs to reduce the risk of transmission. If you take a combination of antiretoviral drugs during pregnancy and delivery, and your newborn receives one of these drugs, the chance of transmission drops to about 1%.
Other strategies that can help to reduce the risk of infection include a shortened delivery time, and in some circumstances delivery by Cesarean section.
If I take antiretroviral drugs during pregnancy, will that hurt my baby?
The use of antiretroviral drugs in prevention programs began around 1994, therefore, the number of women who have taken these drugs is still small and the babies born to these women are still young. It is too early to say for sure that there will be no problems. Until now, no major problems have been identified in children exposed to antiretroviral drugs.
HIV INFECTION IN PREGNANCY
In Canada, women of child-bearing age now account for about 20% of newly-diagnosed HIV positive cases. Unless treatment proceeds during pregnancy, 15 to 40 percent of children born to HIV positive pregnant women will acquire the HIV infection. Thereafter, 20% of these children will develop AIDS within their first year and 50% will develop it within 5 years. The need for perinatal treatment is critical, yet little is known about the effects of HIV drugs on the unborn child.
A National Network
A crucial part of the program is the creation of a national network and registry. Current network members include clinics, health science centers and community groups across Canada. Interested healthcare professional and groups are urged to join and help:
°promote the exchange of up-to-date, evidence-based information, and °build a registry of cases for long-term follow-up of pregnancy outcome.
This national collaboration will build study cohorts that are large enough to generate statistically meaningful information and help researchers establish the fetal safety or risk of antiretroviral agents and their combinations. Contributors to this important research effort will be appropriately acknowledged in published findings and reports.
This program is sponsored in part by Health Canada, Glaxo Wellcome and Biochem Therapeutic Inc.
Centres in Canada that Provide Pediatric HIV Care
Oak Tree Clinic
4500 Oak Street
Vancouver, BC V6H 3N1
Winnipeg Children’s Hospital
840 Sherbrooke Street
Winnipeg, MB R3A 1S2
Alberta Children’s Provincial General Hospital
1820 Richmond Road SW
Calgary, AB T2T 5C7
Paediatric Infectious Disease Clinic
Walter Mackenzie Health Sci. Ctr
2C3, 79 Edmonton, AB T6G 2R7
HIV Care Programme
St. Joseph’s Health Centre of London
448 Oxford Street East
London, ON N5Y 3H6
McMaster University Medical Centre
1200 Main Street West
Hamilton, ON L8N 3Z5
Children’s Hospital of Eastern Ontrio
410 Smyth Road
Ottawa, ON K1H 8L1
The Hospital for Sick Children
Division of Infectious Diseases
555 University Avenue
Toronto, ON M5G 1X8
Centre Maternal et Infantile sur le SIDA
Hopital Ste. Justine
3175 Cote Ste. Catherine
Montreal, QC H3T IC5
The Montreal Children’s Hospital
2300 Tupper Street
Montreal, QC H3H 1P3
Cenre Hopitalier de l’Universite Laval
2705 Boulevard Laurier
Ste.-Foy, QC G1V 4G2
Izak Walton Kilam Children’s Hospital
5850 Universite Avenue
Halifax, NS B3J 3G9
Janeway Hospital Health Science Centre
St. John’s, NF A1A 1R8
In the United States
International Aids Map