Cannabis Use Changed Inflammatory Gene Activity in Immune Cells From People Living With HIV

HIV-positive individuals' macrophages showed 83% higher NLRP3 inflammasome expression than HIV-negative controls. Moderate cannabis users had 61% less IL-1β expression than non-users. CBD treatment reduced NLRP3 expression by 22% in IL-1β-stimulated cells. However, combined CBD + IL-1β treatment unexpectedly increased some downstream cytokine gene expression (3-fold for IL-1β, 2-fold for IL-18).

Cross-sectional study of monocyte-derived macrophages from 43 people with HIV and 22 without HIV. Participants categorized by cannabis use (naïve, moderate, daily). Cells treated with CBD (30 μM), IL-1β (20 ng/mL), or both. NLRP3-related gene expression measured. Clinical correlations assessed.

Chronic inflammation is a major driver of cognitive decline in people living with HIV despite effective antiretroviral therapy. This study provides molecular evidence that cannabis use and CBD may modulate a specific inflammatory pathway (NLRP3) in HIV, offering potential therapeutic insight.

The NLRP3 inflammasome is implicated in numerous inflammatory diseases beyond HIV. Understanding how cannabinoids modulate this pathway could have broad therapeutic implications, though the unexpected increase in downstream cytokines highlights the complexity of cannabinoid-immune interactions.

Cross-sectional — cannot determine causation. In vitro CBD treatment may not reflect in vivo effects. Cannabis use was self-reported and products varied. Small sample. Unexpected downstream effects complicate interpretation.