Journal Article

Cannabis Use and Reduced Risk of Insulin Resistance in HIV-HCV Infected Patients: A Longitudinal Analysis (ANRS CO13 HEPAVIH)

Vilotitch, Antoine, Carrieri, Maria Patrizia, Poizot-Martin, Isabelle, Roux, Perrine, Serfaty, Lawrence, Winnock, Maria, Lions, Caroline, Spire, Bruno, Lascoux-Combe, Caroline, Salmon-Ceron, Dominique, Loko, Marc-Arthur, Dabis, Francois

2015

Overview

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.

• Publisher: Oxford University Press,Oxford University Press (OUP)
• Subject: Adult / ARTICLES AND COMMENTARIES / Diabetes / Drug use / Female / France / Hepatitis / Hepatitis C, Chronic - complications / HIV / HIV Infections - complications / Human immunodeficiency virus / Humans / Insulin Resistance / Life Sciences / Longitudinal Studies / Male / Marijuana Abuse - complications / Middle Aged / Risk Assessment / Risk reduction / Sensitivity analysis / Surveys and Questionnaires