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Does Marijuana Help or Hurt With HIV?

Medically Reviewed by Arefa Cassoobhoy, MD, MPH on June 08, 2020

If you have HIV, the virus that causes AIDS, you might wonder if marijuana -- medicinal or recreational -- can help or if there are risks. The key treatment for HIV is antiretroviral therapy (ART). Some people use marijuana not to treat the virus itself but to ease HIV-related symptoms like weight loss, appetite problems, and nerve pain.

Smoking anything is bad for your lungs, but there are also edibles and related products, including CBD oil and prescription medication made with THC, which comes from marijuana. Though there haven’t been a lot of direct studies on all of those forms, there is some research on what the risks and benefits are.

Marijuana and HIV Nerve Pain

Peripheral neuropathy, or nerve pain, happens when some of your nerves get damaged. You may feel stabbing, burning, or tingling sensations in your hands and feet. HIV and antiretroviral medications can trigger it. HIV also weakens your immune system, which makes it easier to get other infections that might lead to peripheral neuropathy.

There’s not much research on this, but the few studies on the topic suggest that medical marijuana may be helpful.

In one study, researchers gave surveys to 565 people with HIV. Most of those who said they use marijuana reported that their nerve pain got better.

Another research paper notes that THC, the active ingredient in marijuana, eased nerve-related pain in people with cancer, so it might do the same for HIV-related nerve pain. But that hasn’t been proven in a study.

Marijuana and HIV-Related Weight Loss

Wasting is a common symptom of HIV. It’s when you lose lots of weight because you don’t feel well and you’re not as hungry, so you don’t eat enough food. One small study showed marijuana sparked users’ appetite. The FDA has approved the use of dronabinol (Marinol), a THC-containing prescription drug, to stimulate appetite in people with HIV.

Marijuana and Lung Health

Smoking marijuana (or anything else) is bad for your lungs. Marijuana smoke has many of the same toxins, carcinogens, and irritants as tobacco smoke. Research shows smoking marijuana can lead to ongoing issues with bronchitis and related symptoms like coughing, wheezing, and phlegm (the stuff you cough up when you have a cold).

It further weakens an immune system already damaged by HIV. Smoking marijuana affects your lungs' ability to fight infection by killing the cells that help get rid of dust and germs. It also causes you to make more mucus. These things can put you more at risk for respiratory infections. Other forms of marijuana might be a better choice. Your doctor can help you decide within the context of your health and what’s legal in your area.

How Does Marijuana Affect Antiretroviral Medications?

This isn’t clear yet. One study found that people with HIV who used marijuana had problems sticking to their medication and going to the doctor for care. Another reported that marijuana use has little to no effect on viral suppression. But others show it has a positive effect. Given the mixed findings, more research is needed to know what effects there are on these essential medications.

Show Sources

SOURCES:

Mayo Clinic: “Peripheral neuropathy.”

The Foundation for Peripheral Neuropathy: “HIV/AIDS.”

Journal of Pain and Symptom Management: “Cannabis Use in HIV for Pain and Other Medical Symptoms.”

Joy, J. and Mack, A. Marijuana as Medicine? The Science Beyond the Controversy. National Academies Press, 2000.

American Lung Association: “Marijuana and Lung Health.”

Clinical Infectious Diseases: “Effect of Cannabis Use on Human Immunodeficiency Virus DNA During Suppressive Antiretroviral Therapy.”

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