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Distinct inflammatory profiles in HIV-infected individuals under antiretroviral therapy using cannabis, cocaine or cannabis plus cocaine

Castro, Fernanda de Oliveira Feitosa dea; Silva, Jacyelle Medeirosa; Dorneles, Gilson Piresb; Barros, Jéssica Barletto de Sousac; Ribeiro, Camila Bastosa; Noronha, Isaúc; Barbosa, Gabriela Rodriguesc; Souza, Luiz Carlos Silvaa; Guilarde, Adriana Oliveiraa; Pereira, Ana Joaquina Cohen Seriqued; Guimarães, Regyane Ferreirae; Oliveira, Tiago Franco def; Oliveira, Sarah Eller Franco def; Peres, Alessandrab; Romão, Pedro Roosevelt Torresb; Pfrimer, Irmtraut Araci Hoffmannc,*; Fonseca, Simone Gonçalves daa,g,*

doi: 10.1097/QAD.0000000000002296

Objectives: To evaluate the effects of cannabis and/or cocaine use on inflammatory, oxidative stress status and circulating monocyte subsets in HIV-infected individuals under antiretroviral therapy.

Design: Soluble CD14 (sCD14), intestinal fatty acid-binding protein (IFABP), tumor necrosis factor-alpha (TNF-α), interleukin (IL)-6, IL-8, IL-10, C-reactive protein (CRP) and oxidative stress markers were examined. The monocyte subsets and their activation and cytokine production by peripheral blood mononuclear cells (PBMCs) of HIV-1 infected individuals upon lipopolysaccharide (LPS)-stimulation were also investigated.

Methods: sCD14, IFABP, TNF-α, IL-6, IL-8 and IL-10 levels were evaluated using ELISA, CRP by turbidimetry; lipid peroxidation (TBARS) spectrofluometrically and total thiol levels by using 5–5′-dithio-bis (2-nitrobenzoic acid) reagent. Monocyte subsets and activation were assessed by flow cytometry.

Results: All HIV-infected drug user groups showed higher sCD14 levels compared with HIV+ nondrug users. IFABP was increased in HIV+ drug-users in relation to healthy individuals. Cannabis use lowered the percentages of inflammatory, nonclassical, activated-classic and activated-inflammatory monocytes. Cocaine users showed increased plasmatic TNF-α and TBARS levels, decreased thiols content and lower activated-classic and inflammatory-monocyte percentages. Cannabis-plus-cocaine use increased CRP, IL-8 and IL-6/IL-10 ratio, but decreased thiol content, and inflammatory and activated-classic monocyte percentages. PBMCs of cannabis and cannabis-plus-cocaine users showed low-potential cytokine production either spontaneously or under LPS-stimulation.

Conclusion: In HIV infection, the use of cannabis induces predominantly an anti-inflammatory profile. The use of cocaine and cannabis-plus-cocaine showed a mixed pro-inflammatory and anti-inflammatory profile, with predominance of inflammatory status. Further studies are required to better understand the action of these drugs in HIV infection.

aInstituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Goiânia, Goiás

bLaboratório de Imunologia Celular e Molecular, Programa de Pós-Graduação em Ciências da Saúde, Programa de Pós-Graduação em Ciências da Reabilitação, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS

cPontifícia Universidade Católica de Goiás, PUC Goiás, Goiânia, Goiás

dHospital de Doenças Tropicais de Goiás, HDT, Goiânia, Goiás

eHospital das Clínicas Dr Serafim de Carvalho, Jataí, Goiás

fDepartamento de Farmacociências, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS

giii-INCT-Instituto de Investigação em Imunologia – Instituto Nacional de Ciência e Tecnologia, Brazil.

Correspondence to Simone Gonçalves da Fonseca, PhD, Instituto de Patologia Tropical e Saúde Pública – Universidade Federal de Goiás, Rua 235 S/N – Setor Universitário, 74605-050 Goiânia, Goiás, Brazil. Tel: +55 62 32096111; fax: +55 62 32096363; e-mail:

Received 27 March, 2018

Revised 14 April, 2019

Accepted 21 May, 2019

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