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Cannabis Use, Cognition, and the Endocannabinoid System in HIV

Early Phase 1
Recruiting
Conditions
HIV-1-infection
Interventions
Registration Number
NCT04883255
Lead Sponsor
University of California, San Diego
Brief Summary

Understanding how co-morbidities in persons with HIV (PWH) such as substance use affect risk-taking, decision-making, and other cognitive behaviors is important given implications for everyday functioning and transmission risk. The high prevalence of cannabis use in PWH, medicinally and recreationally, may indicate disease severity, impart therapeutic benefits, or adverse consequences. In fact, cannabis is recommended to those with HIV to alleviate nausea, improve appetite, relieve pain, and lift mood. To-date, the consequences of cannabis use in PWH remain unclear as do potential interactions with HIV treatments. In healthy participants, heavy cannabis use is associated with cognitive deficits e.g., risky decision-making, response disinhibition and inattention, but pro-cognitive effects in PWH may exist at mild use levels due to its anti-inflammatory and anti-excitotoxic properties. Furthermore, little has been done to determine the effects of cannabis use on the endocannabinoid (EC) system in general or in PWH. This study will determine the effects of the two primary cannabis constituents (Δ9-tetrahydrocannabinol \[THC\], cannabidiol \[CBD\]) vs. placebo on risky decision-making, response inhibition, reward learning, temporal perception, and motivation, plus EC and homovanillic acid (HVA; a surrogate for dopamine activity) levels in HIV+ and HIV- subjects. Participants with infrequent cannabis use will undergo baseline cognitive testing and biomarker assays with antiretrovirals (ART) use quantified. They will be randomized to a 5-day course of either THC, CBD, or placebo and return for follow-up testing and re-assaying of ECs and HVA levels.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
138
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
HIV-positive subjects600 mg cannabidiol (CBD)Adult human subjects seropositive for HIV-1
HIV-positive subjectsPlaceboAdult human subjects seropositive for HIV-1
Healthy Comparison VolunteersPlaceboAdult human subjects without HIV
HIV-positive subjects10 mg Δ9-tetrahydrocannabinol (THC)Adult human subjects seropositive for HIV-1
Healthy Comparison Volunteers600 mg cannabidiol (CBD)Adult human subjects without HIV
Healthy Comparison Volunteers10 mg Δ9-tetrahydrocannabinol (THC)Adult human subjects without HIV
Primary Outcome Measures
NameTimeMethod
change in Iowa Gambling Task score from baseline to post-interventionbaseline and 5 days after drug initiation

This is an experimental measure and not a scale with specific anchor points. Lower scores reflect increased risk-taking

change in Progressive Ratio Task score from baseline to post-interventionbaseline and 5 days after drug initiation

This is an experimental measure and not a scale with specific anchor points. Lower scores reflect lower motivation or willingness to work for a reward.

change in cerebrospinal fluid (CSF) 2-Arachidonoylglycerol (2-AG) quantity from baseline to post-interventionbaseline and 5 days after drug initiation

This is an experimental measure and not a scale with specific anchor points. Lower 2-AG signifies less amounts of this endocannabinoid in the central nervous system.

change in Probabilistic Learning Task score from baseline to post-interventionbaseline and 5 days after drug initiation

This is an experimental measure and not a scale with specific anchor points. Lower scores reflect poorer learning.

change in Human Temporal Bisection Task score from baseline to post-interventionbaseline and 5 days after drug initiation

This is an experimental measure and not a scale with specific anchor points. Scores reflect fast or slow perception of timing.

change in Continuous Performance Task score from baseline to post-interventionbaseline and 5 days after drug initiation

This is an experimental measure and not a scale with specific anchor points. Lower scores reflect worse attention.

change in cerebrospinal fluid (CSF) homovanillic acid (HVA) quantity from baseline to post-interventionbaseline and 5 days after drug initiation

This is an experimental measure and not a scale with specific anchor points. Lower HVA signifies less amounts of this dopamine metabolite in the central nervous system.

change in human Behavioral Pattern Monitor activity and exploration score from baseline to post-interventionbaseline and 5 days after drug initiation

This is an experimental measure and not a scale with specific anchor points. Higher scores reflect motor hyperactivity and increased exploration.

change in prepulse inhibition percentage score from baseline to post-interventionbaseline and 5 days after drug initiation

This is an experimental measure and not a scale with specific anchor points. Lower scores reflect worse sensorimotor gating.

change in cerebrospinal fluid (CSF) anandamide (AEA) quantity from baseline to post-interventionbaseline and 5 days after drug initiation

This is an experimental measure and not a scale with specific anchor points. Lower AEA signifies less amounts of this endocannabinoid in the central nervous system.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

UC San Diego Medical Center-Hillcrest

🇺🇸

San Diego, California, United States

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