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Clin Infect Dis. 2015 Jul 1;61(1):40-8. doi: 10.1093/cid/civ217. Epub 2015 Mar 16.

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

Collaborators (200)

Salmon D, Dabis F, Winnock M, Loko MA, Sogni P, Benhamou Y, Trimoulet P, Izopet J, Paradis V, Spire B, Carrieri P, Katlama C, Pialoux G, Valantin MA, Bonnard P, Poizot-Martin I, Marchou B, Rosenthal E, Garipuy D, Bouchaud O, Gervais A, Lascoux-Combe C, Goujard C, Lacombe K, Duvivier C, Vittecoq D, Neau D, Morlat P, BaniSadr F, Meyer L, Boufassa F, Dominguez S, Autran B, Roque AM, Solas C, Fontaine H, Serfaty L, Chêne G, Costagliola D, Zucman D, Simon A, Dominguez S, Billaud E, Miailhes P, Polo Devoto J, Couffin-Cadiergues S, Mehawej H, Terris B, Makhlouf Z, Dubost G, Tessier F, Gibault L, Beuvon F, Chambon E, Lazure T, Krivine A, Katlama C, Valantin MA, Stitou H, Benhamou Y, Charlotte F, Fourati S, Simon A, Cacoub P, Nafissa S, Zaegel O, Ménard A, Geneau P, Tamalet C, Pialoux G, Bonnard P, Bani-Sadr F, Slama L, Lyavanc T, Callard P, Bendjaballah F, Le-Pendeven C, Marchou B, Alric L, Barange K, Metivier S, Fooladi A, Selves J, Nicot F, Rosenthal E, Durant J, Haudebourg J, Saint-Paul MC, Bouchaud O, Ziol M, Baazia Y, Uzan M, Bicart-See A, Garipuy D, Ferro-Collados MJ, Selves J, Nicot F, Yéni P, Gervais A, Adle-Biassette H, Molina JM, Lascoux Combe C, Bertheau P, Duclos J, Palmer P, Girard PM, Lacombe K, Campa P, Wendum D, Cervera P, Adam J, Harchi N, Delfraissy JF, Goujard C, Quertainmont Y, Pallier C, Vittecoq D, Lortholary O, Duvivier C, Shoai-Tehrani M, Neau D, Morlat P, Lacaze-Buzy L, Caldato S, Bioulac-Sage P, Trimoulet P, Reigadas S, Zucman D, Majerholc C, Guitard F, Boue F, Polo Devoto J, Kansau I, Chambrin V, Pignon C, Berroukeche L, Fior R, Martinez V, Deback C, Lévy Y, Dominguez S, Lelièvre JD, Lascaux AS, Melica G, Raffi F, Billaud E, Alavena C, Rodallec A, Peyramond D, Chidiac C, Miailhes P, Ader F, Biron F, Boibieux A, Cotte L, Ferry T, Perpoint T, Koffi J, Zoulim F, Bailly F, Lack P, Maynard M, Radenne S, Amiri M, Beniken D, Ritleng AS, Azar M, Honoré P, Breau S, Joulie A, Mole M, Bolliot C, Chouraqui F, Touam F, André F, Ouabdesselam N, Partouche C, Alexandre G, Ganon A, Champetier A, Hue H, Brosseau D, Brochier C, Thoirain V, Rannou M, Bornarel D, Gillet S, Delaune J, Pambrun E, Dequae-Merchadou L, Frosch A, Maradan G, Cheminat O, Marcellin F, Mora M, Protopopescu C, Roux P, Lions C, Loko MA, Winnock M.

Author information

1
Institut national de la santé et de la recherche médicale (INSERM), Unité mixte de recherche (UMR)912 (Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale [SESSTIM]) Aix Marseille Université, UMR_S912, Institut de recherche pour le développement Observatoire Régional de la Santé Provence-Alpes-Côte-d'Azur, Marseille.
2
Service d'hépatologie, Hôpital Saint-Antoine, Assistance publique - Hôpitaux de Paris (APHP), INSERM UMR_938, Université Pierre&Marie-Curie, Paris.
3
INSERM, U897 and Institut de santé publique d'épidémiologie et de développement, Université Victor Segalen, Bordeaux.
4
Aix-Marseille Université, Assistance Publique - Hôpitaux de Marseille Sainte-Marguerite, Service d'Immuno-hématologie Clinique, INSERM U912 (SESSTIM).
5
Hopital Saint-Louis.
6
Service des Maladies Infectieuses et Tropicales, Hôpital Cochin, APHP- Université Paris Descartes, France.

Abstract

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.

KEYWORDS:

HCV; HIV; cannabis; cohort study; insulin resistance

PMID:
25778750
DOI:
10.1093/cid/civ217
[Indexed for MEDLINE]

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