Consequences of Marijuana Use in HIV-infected Youth

Completed

Brief Summary: Proposed study focuses on Youth With HIV (YWH) recruited from the University of North Carolina using a cross sectional assessment of blood samples, clinical, demographic, behavioral, \[including substance use and frequency\], and neurocognitive data will be evaluated from YWH treated before CD4 T cell decline.

Detailed Description: The long-term goal for the proposed research is to apply a systems biology approach to discover evidence that provides the basis for understanding the complex and at times conflicting roles for marijuana in chronic inflammation in HIV-infected youth. To achieve the goal, a systems biology approach with two aims is designed:

Aim 1. To identify inflammatory immune pathways perturbed by recreational marijuana with or without concomitant use of tobacco products by applying a deep sequencing approach to define global transcriptome of peripheral blood cells from HIV-infected virally suppressed youth.

Aim 2. To develop biomarker profiles associated with pro- or anti-inflammatory pathways perturbed by marijuana and to discover biomarker profiles linked to neurocognitive impairment that are impacted by marijuana and tobacco use by YWH

Recruitment & Eligibility

Inclusion Criteria

Age 21 years 0 days - less than28 years 364 days
Currently treated with stable ART and no ART changes for >6months.
Willingness to participate in CASI questionnaire of self-reported substance use
Documented behavioral transmission of HIV infection based on CLIA approved HIV antibody/antigen based testing method in medical record -HIV diagnosis greater than or equal to years. Viral load LESS THAN 50 COPIES/ML for the past 6 months. --

Patients may have had single blips in viral load to greater than 50 but less than 1000 copies/ml within the year prior to screening.

Current Substance profile by chart review or phone screening:
Marijuana use defined as marijuana use by any route at least 3 times per week in the absence of tobacco. N= 20.
Tobacco use only based on report of regular (at least 3 times per week smoking). N=24
Tobacco plus marijuana use defined as regular smoking and marijuana (at least 3 times per week) N =7
No substance use of any type (alcohol, tobacco, marijuana or other recreational drugs in the past 90 days). N = 10
Able to provide written informed consent in English and to adhere to protocol schedule

Exclusion Criteria

History of AIDS defining illness
Pregnancy at any time during the study
Use of substances that would interfere with the ability to complete the study
History of significant cognitive or motor impairment or other chronic condition that would interfere with the ability to complete the study and impact neurocognitive testing
Acute psychiatric symptoms (e.g. suicidality, mania, psychosis or severe depression)
Other neurological disorder (e.g. multiple sclerosis, seizure disorder, etc.) requiring ongoing treatment or active outpatient evaluation
Severe mental illness (requiring antipsychotic or mood stabilizing medications and/or inpatient hospitalization in past year)
History of CNS infection (AIDS opportunistic (e.g. toxoplasmosis) or non-opportunistic (bacterial meningitis) with lasting or permanent neurological sequelae)
Underlying and/or uncontrolled medical illnesses that may result in chronic inflammation , (e.g. SLE or autoimmune disease) as determined by the PI
Nursing mothers
Unable to read and write in English

Primary Outcome Measures

Name	Time	Method
Neurocognitive function as measured by Brief Symptom Inventory	24 months
Neurocognitive function as measured by ASSIST (substance abuse)	24 months
Neurocognitive function as measured by Activities of Daily Living Questionnaire	24 months
Neurocognitive function as measured by the Brief Visuospatial Memory Test-R	24 months
Number of bio-marker pathways that are abnormal.	24 months	This is measured by molecular mechanism of chronic macrophage activation.
Plasma levels of sCD163	24 months	Chi-square test will be used to compare discrete variables
Neurocognitive function as measured by WAIS-III (5 subtest IQ estimate)	24 months
Neurocognitive function as measured by Grooved Pegboard test	24 months
Neurocognitive function as measured by Timed Gait Test	24 months
Neurocognitive function as measured by Beck Depression Inventory-II	24 months
Neurocognitive function as measured by Base ATN Adherence Questions	24 months
Neurocognitive function as measured by Trial Making Test (TMT)	24 months
Neurocognitive function as measured by the WRAT-4 Word Reading subtest	24 months
Neurocognitive function as measured by Hopkins Verbal Learning Test-R	24 months
Neurocognitive function as measured by Behavior Rating Inventory of Executive Functioning	24 months
Neurocognitive function as measured by Verbal Fluency Test	24 Months

Secondary Outcome Measures

Name	Time	Method

Locations (2): Duke UMC
🇺🇸
Durham, North Carolina, United States
Duke University Medical Center
🇺🇸
Durham, North Carolina, United States