consequences of marijuana use in hiv-infected youth

Conditions: Youth With HIV

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.

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

Eligibility criteria:
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

Keywords: substance use