“The main psychoactive component in cannabis-Δ⁹-tetrahydrocannabinol-is known to have anti-inflammatory properties and to alter gamma oscillations, pointing to its potential as a therapeutic agent for people with HIV (PWH). However, it remains unknown how cannabis use among PWH interacts with the neural circuitry underlying inhibitory processing.

Herein, using a cross-sectional study design, we collected data from 108 cannabis users and non-users with and without HIV. Participants were interviewed regarding their substance use history and completed a paired-pulse somatosensory stimulation paradigm during magnetoencephalography (MEG). MEG data were imaged using a beamformer and peak voxel time series data were extracted to examine neural oscillations in response to the stimulation and the strength of spontaneous activity in the same tissue during the baseline period. Across all participants, we observed robust gamma oscillations following stimulation in the left primary somatosensory cortices, with responses to the second stimulation being strongly attenuated relative to the first, thus demonstrating somatosensory gating.

PWH who used cannabis exhibited stronger oscillatory gamma activity compared with non-users with HIV, while the latter group also exhibited elevated spontaneous gamma activity relative to all other groups. Finally, we found that a longer duration of time since HIV diagnosis was associated with less efficient inhibitory processing among PWH who did not use cannabis, but not among PWH who regularly use cannabis.

These findings provide new evidence that cannabis use may mitigate the harmful effects of HIV on oscillatory and spontaneous gamma activity serving inhibitory processing.”

https://pubmed.ncbi.nlm.nih.gov/40421314/

“Taken together, these findings suggest that regular cannabis use may have a neuroprotective effect on inhibitory processing in PWH by normalising spontaneous gamma activity and enhancing gamma oscillatory responses during sensory gating. This pattern indicates that cannabis use could potentially mitigate some of the neural disruptions associated with HIV, highlighting a promising target for future interventions aimed at preserving cognitive function in this population. Importantly, the capacity of cannabis to influence gamma dynamics underscores the broader role of the endocannabinoid system in shaping neural function in the context of HIV-related neuropathology.”

https://academic.oup.com/braincomms/article/7/3/fcaf190/8132827?login=false

“Given the high prevalence of cannabis use among people with HIV (PWH) and its potential to modulate immune responses and reduce inflammation, this systematic review examines preclinical evidence on how tetrahydrocannabinol (THC), a key compound in cannabis, affects gene and micro-RNA expression in simian immunodeficiency virus (SIV)-infected macaques and HIV-infected human cells.

Through a comprehensive search, 19 studies were identified, primarily involving SIV-infected macaques, with a pooled sample size of 176, though methodological quality varied across the studies. Pathway analysis of differentially expressed genes (DEGs) and miRNAs associated with THC revealed enrichment in pathways related to inflammation, epithelial cell proliferation, and adhesion. Notably, some DEGs were targets of the differentially expressed miRNAs, suggesting that epigenetic regulation may contribute to THC’s effects on gene function.

These findings indicate that THC may help mitigate chronic immune activation in HIV infection by altering gene and miRNA expression, suggesting its potential immunomodulatory role. However, the evidence is constrained by small sample sizes and inconsistencies across studies. Further research employing advanced methodologies and larger cohorts is essential to confirm THC’s potential as a complementary therapy for PWH and fully elucidate the underlying mechanisms, which could inform targeted interventions to harness its immunomodulatory effects.”

https://pubmed.ncbi.nlm.nih.gov/40141240/

https://www.mdpi.com/1422-0067/26/6/2598

“Purpose of review: This review explores how cannabis impacts the gut microbiome, immune system, and ART outcomes in people with HIV (PWH). Given the increasing prevalence of cannabis use among PWH, we investigated its potential to reduce chronic inflammation and enhance gut health, both of which can influence HIV pathogenesis.

Recent findings: Cannabis has immunomodulatory and anti-inflammatory effects, including reducing systemic inflammatory biomarkers (such as MCP-1 and IP-10) and improving gut barrier integrity through increased short-chain fatty acid (SCFA) production.

Studies have shown that cannabis use is associated with increased gut mucosal immunity, decreased immune activation, and a unique microbiome composition. Preliminary evidence indicates that cannabis may influence HIV reservoirs, although the results remain inconclusive.

Cannabis shows promise in managing inflammation, gut dysbiosis, and immune dysfunction in PWH. However, its effects on HIV reservoirs, adherence to antiretroviral therapy, and long-term outcomes need further investigation through rigorous clinical trials using standardized formulations.”

https://pubmed.ncbi.nlm.nih.gov/39984806/

https://link.springer.com/article/10.1007/s11904-025-00729-0

“Background: Human immunodeficiency virus 1 (HIV-1) tissue reservoirs remain the main obstacle against an HIV cure. Limited information exists regarding cannabis’s effects on HIV-1 infections in vivo, and the impact of cannabis use on HIV-1 parenchymal tissue reservoirs is unexplored.

Methods: To investigate whether cannabis use alters HIV-1 tissue reservoirs, we systematically collected 21 postmortem brain and peripheral tissues from 20 men with subtype C HIV-1 and with suppressed viral load enrolled in Zambia, 10 of whom tested positive for cannabis use. The tissue distribution and copies of subtype C HIV-1 LTR, gag, env DNA and RNA, and the relative mRNA levels of cytokines IL-1β, IL-6, IL-10, and TGF-β1 were quantified using PCR-based approaches. Utilizing generalized linear mixed models we compared persons with HIV-1 and suppressed viral load, with and without cannabis use.

Results: The odds of tissues harboring HIV-1 DNA and the viral DNA copies in those tissues were significantly lower in persons using cannabis. Moreover, the transcription levels of proinflammatory cytokines IL-1β and IL-6 in lymphoid tissues of persons using cannabis were also significantly lower.

Conclusions: Our findings suggested that cannabis use is associated with reduced sizes and inflammatory cytokine expression of subtype C HIV-1 reservoirs in men with suppressed viral load.”

https://pubmed.ncbi.nlm.nih.gov/38243412/

https://academic.oup.com/jid/advance-article-abstract/doi/10.1093/infdis/jiad575/7577694?redirectedFrom=fulltext&login=false