Cannabis Use, Cognition, and the Endocannabinoid System in HIV
Status:
Not yet recruiting
Trial end date:
2026-01-31
Target enrollment:
Participant gender:
Summary
Understanding how co-morbidities in persons with HIV (PWH) such as substance use affect
risk-taking, decision-making, and other cognitive behaviors is important given implications
for everyday functioning and transmission risk. The high prevalence of cannabis use in PWH,
medicinally and recreationally, may indicate disease severity, impart therapeutic benefits,
or adverse consequences. In fact, cannabis is recommended to those with HIV to alleviate
nausea, improve appetite, relieve pain, and lift mood. To-date, the consequences of cannabis
use in PWH remain unclear as do potential interactions with HIV treatments. In healthy
participants, heavy cannabis use is associated with cognitive deficits e.g., risky
decision-making, response disinhibition and inattention, but pro-cognitive effects in PWH may
exist at mild use levels due to its anti-inflammatory and anti-excitotoxic properties.
Furthermore, little has been done to determine the effects of cannabis use on the
endocannabinoid (EC) system in general or in PWH. This study will determine the effects of
the two primary cannabis constituents (Δ9-tetrahydrocannabinol [THC], cannabidiol [CBD]) vs.
placebo on risky decision-making, response inhibition, reward learning, temporal perception,
and motivation, plus EC and homovanillic acid (HVA; a surrogate for dopamine activity) levels
in HIV+ and HIV- subjects. Participants with infrequent cannabis use will undergo baseline
cognitive testing and biomarker assays with antiretrovirals (ART) use quantified. They will
be randomized to a 5-day course of either THC, CBD, or placebo and return for follow-up
testing and re-assaying of ECs and HVA levels.