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The Impact of Cannabis Use on Cognition in People with HIV: Evidence of Function-Dependent Effects and Mechanisms from Clinical and Preclinical Studies

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Abstract

Purpose of Review

Cannabis may have beneficial anti-inflammatory effects in people with HIV (PWH); however, given this population’s high burden of persisting neurocognitive impairment (NCI), clinicians are concerned they may be particularly vulnerable to the deleterious effects of cannabis on cognition. Here, we present a systematic scoping review of clinical and preclinical studies evaluating the effects of cannabinoid exposure on cognition in HIV.

Recent Findings

Results revealed little evidence to support a harmful impact of cannabis use on cognition in HIV, with few eligible preclinical data existing. Furthermore, the beneficial/harmful effects of cannabis use observed on cognition were function-dependent and confounded by several factors (e.g., age, frequency of use).

Summary

Results are discussed alongside potential mechanisms of cannabis effects on cognition in HIV (e.g., anti-inflammatory), and considerations are outlined for screening PWH that may benefit from cannabis interventions. We further highlight the value of accelerating research discoveries in this area by utilizing translatable cross-species tasks to facilitate comparisons across human and animal work.

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Abbreviations

2-AG:

2-Arachidonoylglycerol

AEA:

N-Arachidonoylethanolamine (anandamide)

AIDS:

Acquired immunodeficiency syndrome

BBB:

Blood-brain barrier

cART:

Combination antiretroviral therapy

CMT2:

Color Trails Test 2

CPT:

Continuous performance task

CUD:

Cannabis use disorder

CB1R:

Cannabinoid-1 receptor

CB2R:

Cannabinoid-2 receptor

CBD:

Cannabidiol

CNS:

Central nervous system

CU:

Cannabis use

EAT:

Error-awareness task

eCB:

Endocannabinoid

EF:

Executive function

FAAH:

Fatty acid amide hydrolase

FIV:

Feline immunodeficiency virus

fMRI:

Functional magnetic resonance imaging

GDS:

Global deficit score

IL:

Infralimbic

IP-10:

Interferon gamma-induced protein (IP-10)

MAGL:

Monoacylglycerol lipase

MCP-1:

Monocyte chemoattractant protein-1

METH:

Methamphetamine

mPFC:

Medial prefrontal cortex

MRI:

Magnetic resonance imaging

MWM:

Morris water maze

NCI:

Neurocognitive impairment

PFC:

Prefrontal cortex

PL:

Procedural learning

PM:

Prospective memory

PRLT:

Probabilistic reversal learning task

PWH:

People with HIV

PWoH:

People with out HIV

RPT:

Rotary pursuit task

rsFC:

Resting-state functional connectivity

SIV:

Simian immunodeficiency virus

SMT:

Star mirror tracing task

SUD:

Substance use disorder

THC:

Δ9-Tetrahydrocannabinol (THC)

TMTA:

Trail Making Test A

tg:

Transgenic

WPT:

Weather prediction task

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Funding

SMA supported by 2R25MH081482-16 and BMH supported by T32MH018399.

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Authors and Affiliations

  1. Department of Psychiatry, University of California San Diego, 9500 Gilman Drive MC 0804, La Jolla, CA, 92093-0804, USA

    Samantha M. Ayoub, Breanna M. Holloway, Alannah H. Miranda, Benjamin Z. Roberts, Jared W. Young & Arpi Minassian

  2. Department of Neuroscience, University of California San Diego, La Jolla, CA, USA

    Ronald J. Ellis

  3. Research Service, VA San Diego Healthcare System, San Diego, CA, USA

    Jared W. Young

  4. VA Center of Excellence for Stress and Mental Health, Veterans Administration San Diego HealthCare System, 3350 La Jolla Village Drive, San Diego, CA, USA

    Arpi Minassian

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  1. Samantha M. Ayoub
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Contributions

All authors contributed to the conceptual design of the manuscript. SMA, BMH, AHM and BZR performed the systematic review search and first draft of the manuscript. All authors equally contributed to subsequent drafts and editing of the full written manuscript.

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Correspondence to Samantha M. Ayoub.

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Arpi Minassian and Ronald J. Ellis are co-senior authors.

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Ayoub, S.M., Holloway, B.M., Miranda, A.H. et al. The Impact of Cannabis Use on Cognition in People with HIV: Evidence of Function-Dependent Effects and Mechanisms from Clinical and Preclinical Studies. Curr HIV/AIDS Rep (2024). https://doi.org/10.1007/s11904-024-00698-w

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