Cannabis Use Did Not Affect Immune Cell Counts in HIV-Hepatitis C Co-Infected Patients

Among 955 HIV-HCV co-infected patients on antiretroviral therapy, cannabis use showed no significant effect on CD4 T-cell counts or percentages, providing reassurance for immunocompromised patients who use cannabis.

Marcellin, Fabienne et al.·Drug and alcohol review·2017·Moderate EvidenceLongitudinal Cohort
RTHC-01450Longitudinal CohortModerate Evidence2017RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Longitudinal Cohort
Evidence
Moderate Evidence
Sample
N=955

What This Study Found

This large longitudinal study examined whether cannabis use affects the most important immune marker in HIV management, the CD4 T-cell count, in patients co-infected with both HIV and hepatitis C.

Among 955 patients followed over multiple visits (2,386 total visits), cannabis use was remarkably common: 48% reported use in the preceding four weeks. Of cannabis users, 58% also smoked 10 or more tobacco cigarettes daily.

After multiple statistical adjustments, cannabis use was not significantly associated with either CD4 T-cell count or CD4 T-cell percentage. Sensitivity analyses excluding tobacco users and heavy smokers confirmed the null finding.

This is clinically important because HIV-HCV co-infected patients often use cannabis for symptom management, and concerns about immunosuppression could theoretically limit its use in this already immunocompromised population.

Key Numbers

955 patients, 2,386 visits. 48% reported cannabis use. Cannabis use coefficient for CD4 count: 0.27 (95% CI -0.07 to 0.62, p=0.12). Cannabis use coefficient for CD4 percentage: -0.04 (95% CI -0.45 to 0.36, p=0.83).

How They Did This

Longitudinal analysis of the ANRS CO13-HEPAVIH French cohort. Cannabis use assessed via annual self-administered questionnaires in 955 patients (2,386 visits). CD4 T-cell count and percentage analyzed using multivariate linear regression with generalized estimating equations. Sensitivity analyses excluded tobacco users.

Why This Research Matters

HIV-HCV co-infected patients already face compromised immune function. If cannabis further reduced CD4 counts, it could accelerate disease progression. This study provides evidence-based reassurance that cannabis use does not measurably harm this critical immune parameter.

The Bigger Picture

While this study is reassuring about circulating CD4 counts, the authors note that cannabis could affect immune cells in other locations (like the lungs) or affect cell function without changing counts. The overall finding supports cannabis as relatively safe from an immune standpoint in this population.

What This Study Doesn't Tell Us

CD4 count and percentage are crude measures of immune function that do not capture cell functionality. Self-reported cannabis use may be inaccurate. The study did not assess cannabis dose, type, or administration route. All patients were on antiretroviral therapy, which itself maintains CD4 counts.

Questions This Raises

  • ?Does cannabis affect CD4 cell function (ability to fight infections) even if counts remain stable?
  • ?Are there effects on other immune cells (CD8, NK cells) not measured in this study?
  • ?Would cannabis interact with specific antiretroviral medications?

Trust & Context

Key Stat:
No effect of cannabis on CD4 T-cell counts in 955 HIV-HCV co-infected patients
Evidence Grade:
Large longitudinal cohort with multiple visits and statistical adjustments. Moderate because of comprehensive methodology despite self-reported cannabis use and limited immune markers.
Study Age:
Published in 2017.
Original 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).
Published In:
Drug and alcohol review, 36(2), 227-238 (2017)
Database ID:
RTHC-01450

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-ControlFollows or compares groups over time
This study
Cross-Sectional / Observational
Case Report / Animal Study

Follows a group of people over time to track how outcomes develop.

What do these levels mean? →

Frequently Asked Questions

Does cannabis weaken the immune system in HIV patients?

This study found no evidence that cannabis use affected CD4 T-cell counts or percentages in 955 HIV-HCV co-infected patients on treatment. This provides reassurance, though other aspects of immune function were not measured.

Is cannabis safe for people with HIV?

From the standpoint of CD4 counts (the most important immune marker in HIV management), this study found no negative effect of cannabis. Nearly half of patients used cannabis, suggesting its use is common and not associated with immune deterioration in this context.

Read More on RethinkTHC

Cite This Study

RTHC-01450·https://rethinkthc.com/research/RTHC-01450

APA

Marcellin, Fabienne; Lions, Caroline; Rosenthal, Eric; Roux, Perrine; Sogni, Philippe; Wittkop, Linda; Protopopescu, Camelia; Spire, Bruno; Salmon-Ceron, Dominique; Dabis, François; Carrieri, Maria Patrizia. (2017). 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).. Drug and alcohol review, 36(2), 227-238. https://doi.org/10.1111/dar.12398

MLA

Marcellin, Fabienne, et al. "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).." Drug and alcohol review, 2017. https://doi.org/10.1111/dar.12398

RethinkTHC

RethinkTHC Research Database. "No significant effect of cannabis use on the count and perce..." RTHC-01450. Retrieved from https://rethinkthc.com/research/marcellin-2017-no-significant-effect-of

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.