Health outcomes and cognitive effects of marijuana use among persons living with HIV/AIDS

吸食大麻对艾滋病毒/艾滋病患者的健康结果和认知影响

• 批准号: 9893854
• 负责人: Robert L Cook
• 金额: $ 63.6万
• 依托单位: UNIVERSITY OF FLORIDA
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-08-15 至 2022-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9893854
• 关键词: AIDS/HIV problem; Acute; Adherence; Affect; Age; Amendment; Anti-Inflammatory Agents; Behavior; Behavioral; Behavioral Mechanisms; Biological; Biological Markers; CD4 Lymphocyte Count; Cannabinoids; Cannabis; Caring; Characteristics; Chronic; Clinical; Clinical Management; Cognition; Cognitive; Cognitive deficits; Cohort Studies; Community Health; Data; Disease; Disease Progression; Florida; Gender; Goals; HIV; HIV Infections; Health; Health Personnel; Health Policy; Healthcare; Impaired cognition; Incidence; Individual; Inflammation; Infrastructure; Intention; Interdisciplinary Study; Intoxication; Legal; Long-Term Effects; Longitudinal cohort; Longitudinal cohort study; Marijuana; Measures; Mediating; Medical Marijuana; Memory; Monitor; Motivation; Outcome; Patients; Pattern; Persons; Prevalence; Prospective cohort study; Public Health; Publishing; Recommendation; Recording of previous events; Research; Research Infrastructure; Research Priority; Risk Factors; Sampling; Subgroup; Substance Use Disorder; Symptoms; Time; United States National Institutes of Health; Urine; Viral; Viremia; cognitive function; cohort; comorbidity; comorbidity Index; cytokine; follow-up; improved; interest; marijuana legalization; marijuana use; marijuana use disorder; marijuana user; medication compliance; multidisciplinary; novel; prospective; prospective memory; recruit; secondary analysis; transmission process

Daily use of marijuana use is increasingly common in persons living with HIV (PLWH). In Florida, which continues to have one of the highest rates of HIV incidence and prevalence in the US, voters are expected to pass an amendment to legalize medical marijuana for use by PLWH in late 2016. While there is some evidence that marijuana can improve HIV-related symptoms, there is almost no existing evidence regarding the long- term health effects of marijuana in PLWH. Marijuana, which contains a number of different cannabinoid products, could affect HIV health outcomes via both behavioral mechanisms (e.g. medication adherence, motivation) and biological mechanisms (e.g. anti-inflammatory, viral suppression). The overarching goals of this study are to obtain evidence regarding the influence of marijuana on major health outcomes and behavior in PLWH in order to help guide clinical recommendations and identify risk factors for consequences. We are especially interested in the relationship of marijuana to novel aspects of cognitive function (e.g. motivation, intention, planning) and to systemic inflammation. To accomplish these research goals, we propose a new, longitudinal cohort of 480 PLWH (160 regular marijuana users, 160 occasional marijuana users, and 160 non- users). We will obtain detailed marijuana assessments, including cannabis biomarkers, together with repeated measures of cognition, systemic inflammation, and HIV care engagement and health outcomes. Our Specific Aims are: 1) To prospectively determine the association of daily and occasional marijuana use with HIV care engagement, viral suppression, and HIV disease progression; 2) to prospectively determine the association of past and current marijuana use with cognitive function, motivation, and planning; and 3) to prospectively determine the association of chronic marijuana use with cytokine markers of chronic inflammation. For each of these aims, we will conduct subgroup analyses to explore whether these relationships vary by individual characteristics such as gender and age (>50 vs. <50), and by characteristics of past and current marijuana use, including cannabis use disorder. This will be the largest prospective cohort study focused on the health effects of marijuana in PLWH. The findings will inform HIV treatment providers and patients who are considering marijuana to manage HIV-related symptoms or HIV disease itself, and will identify patterns of marijuana use that are most strongly associated with the incidence of substance use disorders. Our research team is multidisciplinary, our infrastructure is in place, and our preliminary data support the need for this project. The research is consistent with current NIH HIV research priorities to reduce HIV transmission (by successful treatment and viral suppression) and to reduce the onset of HIV-related comorbidities, including cognitive dysfunction.

在患有艾滋病毒（PLWH）的人中，日常使用大麻的使用越来越普遍。在佛罗里达州 在美国，艾滋病毒发病率和患病率仍然是最高的，预计选民将 通过一项修正案将医用大麻合法化，以便在2016年底使用PLWH使用。虽然有一些证据 大麻可以改善与HIV相关的症状，几乎没有关于长期的证据 大麻在PLWH中的健康影响。大麻，其中包含许多不同的大麻素 产品，可能会通过两种行为机制影响HIV健康结果（例如，药物依从性， 动机）和生物学机制（例如抗炎，病毒抑制）。总体目标 这项研究是为了获得有关大麻对重大健康结果和行为的影响的证据 在PLWH中，以帮助指导临床建议并确定后果的风险因素。我们是 对大麻与认知功能的新方面的关系特别感兴趣（例如动机， 意图，计划）和系统性炎症。为了实现这些研究目标，我们提出了一个新的， 480 PLWH的纵向队列（160个常规大麻使用者，160个偶尔的大麻使用者和160个非 - 用户）。我们将获得包括大麻生物标志物在内的详细大麻评估以及重复 认知，系统性炎症，艾滋病毒护理参与和健康结果的措施。我们的具体 目的是：1）前瞻性确定每日和偶尔使用大麻与艾滋病毒护理的关联 参与，病毒抑制和HIV疾病进展； 2）前瞻性确定 过去和现在的大麻用于认知功能，动机和计划； 3）前瞻性 确定慢性大麻使用与慢性炎症的细胞因子标记的关联。每个 这些目的，我们将进行子组分析，以探索这些关系是否因个人而有所不同 性别和年龄（> 50 vs. <50）等特征，以及过去和当前大麻的特征， 包括大麻使用障碍。这将是针对健康影响的最大的前瞻性队列研究 PLWH中的大麻。这些发现将通知艾滋病毒治疗提供者和正在考虑的患者 大麻管理与艾滋病毒有关的症状或艾滋病毒疾病本身，并将确定使用大麻的模式 与物质使用障碍的发生率最密切相关的。我们的研究团队是 多学科，我们的基础架构已经到位，我们的初步数据支持对该项目的需求。这 研究与当前的NIH HIV研究重点相一致，以减少HIV传播（成功 治疗和抑制病毒）并减少与HIV相关的合并症的发作，包括认知 功能障碍。