title: No significant effect of cannabis use on the count and percentage of circulating CD4 T-cells in HIV-HCV co-infected patients (ANRS CO13-HEPAVIH French cohort).
abstract: Despite cannabis use being very common in patients co-infected with HIV and hepatitis C virus (HCV), its effect on these patients' immune systems remains undocumented. Documenting the potential effect of cannabis use on HIV immunological markers would help caregivers make more targeted health recommendations to co-infected patients. We performed a longitudinal analysis of the relationship between cannabis use and peripheral blood CD4 T-cell measures in co-infected patients receiving antiretroviral therapy.
  
  
  
  Cannabis use was assessed using annual self-administered questionnaires in 955 patients (2386 visits) enrolled in the ANRS CO13-HEPAVIH cohort. The effect of cannabis use on circulating CD4 T-cell count and percentage was estimated using multivariate linear regression models with generalised estimating equations. Sensitivity analyses were conducted after excluding visits where (i) tobacco use and (ii) smoking >=10 tobacco cigarettes/day were reported.
  
  
  
  At the first visit, 48% of patients reported cannabis use during the previous four weeks, and 58% of these patients also smoked ≥10 tobacco cigarettes/day. After multiple adjustment, cannabis use was not significantly associated with either circulating CD4 T-cell count [model coefficient (95% confidence interval): 0.27 (-0.07; 0.62), P = 0.12] or percentage [-0.04 (-0.45; 0.36), P = 0.83]. Sensitivity analyses confirmed these results.
  
  
  
  Findings show no evidence for a negative effect of cannabis use on circulating CD4 T-cell counts/percentages in HIV-HCV co-infected patients. In-depth immunological studies are needed to document whether cannabis has a harmful effect on CD4 levels in lungs and on cells' functional properties. [Marcellin F, Lions C, Rosenthal E, Roux P, Sogni P, Wittkop L, Protopopescu C, Spire B, Salmon-Ceron D, Dabis F, Carrieri MP, HEPAVIH ANRS CO13 Study Group. No significant effect of cannabis use on the count and percentage of circulating CD4 T-cells in HIV-HCV co-infected patients (ANRSCO13-HEPAVIH French cohort). Drug Alcohol Rev 2017;36:227-238].
authors.affiliation: INSERM, UMR_S 912, Sciences Economiques & Sociales de la Santé et Traitement de l'Information Médicale (SESSTIM), F-13385, Marseille, France.|Aix Marseille Université, UMR_S 912, IRD, Marseille, F-13385, Marseille, France.|ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, F-13006, Marseille, France.
authors.forename: Fabienne
authors.initials: F
authors.lastname: Marcellin
authors.affiliation: INSERM, UMR_S 912, Sciences Economiques & Sociales de la Santé et Traitement de l'Information Médicale (SESSTIM), F-13385, Marseille, France.|Aix Marseille Université, UMR_S 912, IRD, Marseille, F-13385, Marseille, France.|ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, F-13006, Marseille, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Lions
authors.affiliation: Nice Sophia-Antipolis University, Nice, France.|Department of Internal Medicine, L'Archet Hospital, Nice, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Rosenthal
authors.affiliation: INSERM, UMR_S 912, Sciences Economiques & Sociales de la Santé et Traitement de l'Information Médicale (SESSTIM), F-13385, Marseille, France.|Aix Marseille Université, UMR_S 912, IRD, Marseille, F-13385, Marseille, France.|ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, F-13006, Marseille, France.
authors.forename: Perrine
authors.initials: P
authors.lastname: Roux
authors.affiliation: Inserm U1016, Hepatology Unit, APHP, Hôpital Cochin, Paris Descartes University, Paris, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Sogni
authors.affiliation: ISPED, Centre INSERM U897-Epidemiology-Biostatistics, Bordeaux University, Bordeaux, France.|ISPED, Centre INSERM U897-Epidemiology-Biostatistics, INSERM, Bordeaux, France.
authors.forename: Linda
authors.initials: L
authors.lastname: Wittkop
authors.affiliation: INSERM, UMR_S 912, Sciences Economiques & Sociales de la Santé et Traitement de l'Information Médicale (SESSTIM), F-13385, Marseille, France.|Aix Marseille Université, UMR_S 912, IRD, Marseille, F-13385, Marseille, France.|ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, F-13006, Marseille, France.
authors.forename: Camelia
authors.initials: C
authors.lastname: Protopopescu
authors.affiliation: INSERM, UMR_S 912, Sciences Economiques & Sociales de la Santé et Traitement de l'Information Médicale (SESSTIM), F-13385, Marseille, France.|Aix Marseille Université, UMR_S 912, IRD, Marseille, F-13385, Marseille, France.|ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, F-13006, Marseille, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Spire
authors.affiliation: Infectious and Tropical Diseases Service, Hôpital Cochin, AP-HP, Paris, France.|Paris Descartes University, Paris, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Salmon-Ceron
authors.affiliation: ISPED, Centre INSERM U897-Epidemiology-Biostatistics, Bordeaux University, Bordeaux, France.|ISPED, Centre INSERM U897-Epidemiology-Biostatistics, INSERM, Bordeaux, France.
authors.forename: François
authors.initials: F
authors.lastname: Dabis
authors.affiliation: INSERM, UMR_S 912, Sciences Economiques & Sociales de la Santé et Traitement de l'Information Médicale (SESSTIM), F-13385, Marseille, France.|Aix Marseille Université, UMR_S 912, IRD, Marseille, F-13385, Marseille, France.|ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, F-13006, Marseille, France.
authors.forename: Maria Patrizia
authors.initials: MP
authors.lastname: Carrieri
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology*; D015331:Cohort Studies; D060085:Coinfection; D005260:Female; D005500:Follow-Up Studies; D005602:France; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000276:immunology*; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D008385:Marijuana Smoking / Q000009:adverse effects* / Q000453:epidemiology; D008875:Middle Aged; D015999:Multivariate Analysis; D011795:Surveys and Questionnaires
chemical_list: D019380:Anti-HIV Agents
keywords: CD4 T-cell; HCV; HIV; cannabis; longitudinal analysis