title: Cannabis Use and Reduced Risk of Insulin Resistance in HIV-HCV Infected Patients: A Longitudinal Analysis (ANRS CO13 HEPAVIH).
abstract: BACKGROUND
  Diabetes and insulin resistance (IR) is common in human immunodeficiency virus-hepatitis C virus (HIV-HCV)-coinfected patients, a population also concerned with elevated cannabis use. Cannabis has been associated with reduced IR risk in some population-based surveys. We determined whether cannabis use was consistently associated with reduced IR risk in HEPAVIH, a French nationwide cohort of HIV-HCV-coinfected patients.
  
  
  METHODS
  HEPAVIH medical and sociobehavioral data were collected (using annual self-administered questionnaires). We used 60 months of follow-up data for patients with at least 1 medical visit where IR (using homeostatic model assessment of insulin resistance [HOMA-IR]) and cannabis use were assessed. A mixed logistic regression model was used to evaluate the association between IR risk (HOMA-IR > 2.77) and cannabis use (occasional, regular, daily).
  
  
  RESULTS
  Among the 703 patients included in the study (1287 visits), 323 (46%) had HOMA-IR > 2.77 for at least 1 follow-up visit and 319 (45%) reported cannabis use in the 6 months before the first available visit. Cannabis users (irrespective of frequency) were less likely to have HOMA-IR > 2.77 (odds ratio [95% confidence interval], 0.4 [.2-.5]) after adjustment for known correlates/confounders. Two sensitivity analyses with HOMA-IR values as a continuous variable and a cutoff value of 3.8 confirmed the association between reduced IR risk and cannabis use.
  
  
  CONCLUSIONS
  Cannabis use is associated with a lower IR risk in HIV-HCV-coinfected patients. The benefits of cannabis-based pharmacotherapies for patients concerned with increased risk of IR and diabetes need to be evaluated in clinical research and practice.
authors.affiliation: Institut national de la santé et de la recherche médicale (INSERM), Unité mixte de recherche (UMR)912 (Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale [SESSTIM]) Aix Marseille Université, UMR_S912, Institut de recherche pour le développement Observatoire Régional de la Santé Provence-Alpes-Côte-d'Azur, Marseille.
authors.forename: Maria Patrizia
authors.initials: MP
authors.lastname: Carrieri
authors.affiliation: Service d'hépatologie, Hôpital Saint-Antoine, Assistance publique - Hôpitaux de Paris (APHP), INSERM UMR_938, Université Pierre&Marie-Curie, Paris.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Serfaty
authors.affiliation: Institut national de la santé et de la recherche médicale (INSERM), Unité mixte de recherche (UMR)912 (Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale [SESSTIM]) Aix Marseille Université, UMR_S912, Institut de recherche pour le développement Observatoire Régional de la Santé Provence-Alpes-Côte-d'Azur, Marseille.
authors.forename: Antoine
authors.initials: A
authors.lastname: Vilotitch
authors.affiliation: INSERM, U897 and Institut de santé publique d'épidémiologie et de développement, Université Victor Segalen, Bordeaux.
authors.forename: Maria
authors.initials: M
authors.lastname: Winnock
authors.affiliation: Aix-Marseille Université, Assistance Publique - Hôpitaux de Marseille Sainte-Marguerite, Service d'Immuno-hématologie Clinique, INSERM U912 (SESSTIM).
authors.forename: Isabelle
authors.initials: I
authors.lastname: Poizot-Martin
authors.affiliation: INSERM, U897 and Institut de santé publique d'épidémiologie et de développement, Université Victor Segalen, Bordeaux.
authors.forename: Marc-Arthur
authors.initials: MA
authors.lastname: Loko
authors.affiliation: Institut national de la santé et de la recherche médicale (INSERM), Unité mixte de recherche (UMR)912 (Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale [SESSTIM]) Aix Marseille Université, UMR_S912, Institut de recherche pour le développement Observatoire Régional de la Santé Provence-Alpes-Côte-d'Azur, Marseille.
authors.forename: Caroline
authors.initials: C
authors.lastname: Lions
authors.affiliation: Hopital Saint-Louis.
authors.forename: Caroline
authors.initials: C
authors.lastname: Lascoux-Combe
authors.affiliation: Institut national de la santé et de la recherche médicale (INSERM), Unité mixte de recherche (UMR)912 (Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale [SESSTIM]) Aix Marseille Université, UMR_S912, Institut de recherche pour le développement Observatoire Régional de la Santé Provence-Alpes-Côte-d'Azur, Marseille.
authors.forename: Perrine
authors.initials: P
authors.lastname: Roux
authors.affiliation: Service des Maladies Infectieuses et Tropicales, Hôpital Cochin, APHP- Université Paris Descartes, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Salmon-Ceron
authors.affiliation: Institut national de la santé et de la recherche médicale (INSERM), Unité mixte de recherche (UMR)912 (Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale [SESSTIM]) Aix Marseille Université, UMR_S912, Institut de recherche pour le développement Observatoire Régional de la Santé Provence-Alpes-Côte-d'Azur, Marseille.
authors.forename: Bruno
authors.initials: B
authors.lastname: Spire
authors.affiliation: INSERM, U897 and Institut de santé publique d'épidémiologie et de développement, Université Victor Segalen, Bordeaux.
authors.forename: Francois
authors.initials: F
authors.lastname: Dabis
mesh_terms: D000328:Adult; D005260:Female; D005602:France; D015658:HIV Infections / Q000150:complications*; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D007333:Insulin Resistance; D008137:Longitudinal Studies; D008297:Male; D002189:Marijuana Abuse / Q000150:complications*; D008875:Middle Aged; D018570:Risk Assessment; D011795:Surveys and Questionnaires
keywords: HCV; HIV; cannabis; cohort study; insulin resistance