In the Journals

Cannabis use lowers risk for insulin resistance in patients with HIV/HCV

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March 20, 2015

Among patients coinfected with HIV and hepatitis C, cannabis use reduced the risk for insulin resistance, according to researchers from INSERM in France.

“This is the first longitudinal study documenting the relationship between the reduced risk of insulin resistance and cannabis use in a population particularly concerned by insulin resistance risk,” the researchers wrote in Clinical Infectious Diseases. “The results found were robust as they were confirmed in three sensitivity analyses, one of [these] also including patients with diabetes.”

M. Patrizia Carrieri, PhD, and colleagues evaluated data from the ANRS HEPAVIH CO-13 cohort, which included patients in France coinfected with HIV and HCV. The data included patient information obtained from self-administered questionnaires, such as HIV and HCV testing, HIV-related symptoms, coffee consumption and drug and alcohol use in the previous month. The questionnaires were completed every 12 months for 60 months.

The analysis included 703 patients. At the first available visit, 54.6% reported no cannabis use in the previous 4 weeks, where as 20.6% reported occasional use, 11.7% regular use and 13.1% daily use. Insulin resistance was measured by the homeostasis model assessment of insulin resistance (HOMA-IR). Forty-six percent of patients had a HOMA-IR of more than 2.77 at one or more follow-up visits, and 30% had a HOMA-IR of more than 3.8.

In a univariate analysis, cannabis use of any frequency was associated with a lower risk for insulin resistance, as was drinking three or more cups of coffee a day, having detectable HIV viral load and being female. Exposure to the antiretroviral D4T and cirrhosis were associated with an elevated risk for insulin resistance.

In a multivariable analysis adjusted for gender, immune-virological status, D4T exposure, BMI, HCV clearance at enrollment, elevated coffee consumption and cirrhosis, the relationship between cannabis use and reduced risk for insulin resistance was confirmed (OR = 0.4; 95% CI, 0.2-0.5). In sensitivity analysis, there also was an association when using a HOMA-IR cut-off value of 3.8 (OR = 0.4; 95% CI, 0.2-0.6), or using continuous HOMA-IR values (coefficient = –0.6; 95% CI, –0.9 to –0.4).

“There are several cannabis-based pharmacotherapies which do not rely on herbal marijuana and are used for specific indications (eg, symptoms relief in multiple sclerosis),” the researchers wrote. “The benefits of these products for patients concerned by increased risk of insulin and diabetes need to be evaluated in clinical research and practice.” – by Emily Shafer

Disclosure: Carrieri reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.

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