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What Is HIV?
HIV stands for human immunodeficiency virus. HIV is spread through semen, blood, vaginal and anal fluids, and breast milk. HIV cannot be transmitted through sweat, saliva, or urine. There is currently effective antiretroviral treatment (combination therapy) so people living with HIV can live a longer, healthy life. The earlier HIV is diagnosed, the sooner treatment can begin and the greater likelihood of long-term health.
HIV testing is critical in lowering the risk of HIV spreading. It can also make it so individuals can address the condition as early as possible.
The most effective way to prevent spreading HIV, and other sexually transmitted infections, is regularly using condoms. If you inject drugs, it is paramount you use a clean needle and syringe and never share needles. During pregnancy, if living with HIV, your blood could pass into your baby’s body or post-birth through breast milk. However, HIV treatments virtually eliminate the risk of transmitting it to your child.
HIV can only be passed person to person if infected body fluids get into your bloodstream via: unprotected sex, mother to child during pregnancy, childbirth, or breastfeeding, injecting drugs with a needle that has infected blood in it, infected blood donations or organ transplants. A current HIV vaccine is in the making but does not currently exist.
HIV kills a specific type of white blood cell called a T-helper cells or CD4 cells. The virus then makes copies of itself inside these cells, allowing the disease to exponentially spread.
What Is AIDS?
AIDS stands for acquired immunodeficiency syndrome and is not a virus. It’s a syndrome caused by the HIV virus. AIDS is also called advanced HIV infection or late-stage HIV. AIDS is characterized by a low T-cell count and the appearance of other infections. When a person is too weak to fight off infection, it is said they have AIDS. They develop characteristic symptoms and illnesses that develop after the HIV infection has destroyed their immune system.
AIDS is the last stage of HIV, when the infection is very advanced and, if left untreated, will lead to death. As testing and treatment for HIV becomes more available and part of regular health care, fewer people are developing AIDS.
It can take a long time for HIV to develop into AIDS, which now occurs only when left untreated. By average, it takes between 10 and 12 years to become AIDS. If HIV is detected before the patient develops AIDS, certain now available medicines can slow or even stop the damage to the immune system.
Though HIV was previously seen as ultimately fatal, modern medicinal advancements enable patients to live full lives. Still, symptoms must be addressed and patients must be particularly cautious with their health, as the disease is still chronic even when managed.
Treatment transformed AIDS from a terminal illness into a chronic disorder, but it has a downside. The very drugs that wondrously give people with HIV their future back, make their day-to-day life miserable.
Symptoms of HIV AIDS
HIV symptoms vary by person and depend on the stage of the viral infection. During the first month of infection, most patients experience flu-like symptoms. This stage is referred to as primary HIV infection or Acute Retroviral Syndrome (ARS). At this stage, the body is having an initial reaction to the viral infection.
Once at the final stage of HIV, when diagnosed with AIDS, symptoms often include fever, swollen glands, rash, sore throat, fatigue, headache, muscle and joint pain, and bodily discomfort.
Medical Marijuana and AIDS
Many AIDS sufferers are turning to the relief of the natural benefits of medical marijuana, not as a cure or to replace the benefits of current treatment, but to ease the pain, nausea, and loss of appetite that often accompany the traditional treatments.
As HIV compromises the immune system and the bodies natural defense shuts down, it struggles to combat diseases and opportunistic infections, such as tuberculosis, bronchitis, meningitis, influenza, and pneumonia.
Much like chemotherapy for cancer sufferers, traditional AIDS treatments involve powerful drugs that lead to vomiting, loss of appetite, and extreme bodily pain. Over the past decade, medical marijuana has shown it may help improve sleep, control nerve pain (neuropathy), increase appetite, prevent weight loss, and reduce nausea.
Additionally, medically marijuana has been thought to lessen stress, anxiety, and depression–via a sense of euphoria–which are all natural responses to HIV and HIV AIDS. Studies have shown that when patients have good mental health, their physical health and overall well-being increases. When less burdened by the bleakness of stress, anxiety, and depression, patients are better able to live happy, long lives.
Though marijuana has proven medicinal value, and is known to alleviate nausea, vomiting, and loss of appetite, and mimic drugs are used for these same medical concerns, each patient is different. Individuals require a health professional’s recommendation and dosage suited to them personally.
Nerve or neuropathic pain often decreases the quality of life of patients with HIV, even with opioid treatments. Cannabinoid receptors, easily targeted by cannabis and chemically-engineered mimic drugs, are located in the peripheral and central nervous system. They have been recently discovered to manage pain sensations sent to the brain and therefore our perception of pain. The cannabinoid receptors are also referred to as the endocannabinoid system, which is only recently being researched into its impact on nerve sensations.
Many clinical studies have found medical marijuana, at profound levels, reduces nausea and increases appetite. Cachexia (muscle wasting) is a common condition in those with the disease. Cannabis therapy has been proven effective in lessening nausea and increasing weight to or stabilizing weight at a healthy level.
A Louisiana State study, published, in the AIDS Research and Human Retroviruses publication, that when THC (Tetrahydrocannabinol) was given to monkeys, over the span of 17 months, it resulted in less immune system damage in the digestive site. Gut immune tissue is a prime target of HIV.
The lead researcher of the Louisiana State study, Dr. Patricia Molina, states, “It adds to the picture and it builds a little bit more information on the potential mechanisms that might be playing a role in the modulation of the infection.”
Many HIV and specifically HIV AIDS sufferers are known to self-medicate by smoking cannabis. While it’s completely reasonable to seek relief, smoking cannabis can lead to other health complications. Ideally medical options would be more widespread in availability so a healthier alternative would be viable for all sufferers.
History of AIDS and Medical Cannabis
According to Clinton A. Werner, The AIDS epidemic and initial lack of effective treatments led to the politicization HIV AIDS patient population. They began to demand research, quicker development, and access to more promising medications.
After many AIDS patients demanded marijuana to treat their loss of appetite and wasting syndrome, from both illness and medications, United States federal government’s Public Health Service closed the only legal source of supply (Compassionate Use Investigational New Drug IND program). The federal authorities lack of compassion and repression of medical research birthed a grassroots movement that rejected federal regulations.
The political influence of the AIDS epidemic and sufferers of AIDS on the movement towards medical marijuana cannot be discounted. The grassroots movement worked to protect patients from arrest for protest. The American population, at large, began to then realize the injustice.
Homophobia and the Dismissal of AIDS Patients
AIDS victims have been stigmatized since the first documented appearances of the disease in the United States. The first hints of the AIDS epidemic came to public notice at the end of the 1970s and in the early 1980 when, in New York City, San Francisco, Los Angeles, doctors began see rare illnesses in young gay men. The first publication, on June 5, 1981, in the Centers for Disease Control and Prevention, in their Morbidity and Mortality Weekly Report printed:
“In the period of October 1980-May 1981, 5 young men, all active homosexuals, were treated for biopsy-confirmed Pneumocystis carinii Pneumonia at three different hospitals in Los Angeles, CA….Pneumocystis pneumonia is also exclusively limited to severely immunosuppressed patients” (CDC, 305-308).
Originally referred to as Gay Related Immune Deficiency (GRID), the demonization of the queer community particularly young gay men formed public opinion on the AIDS epidemic. Medical professions had to discount this association when related symptoms were found in transfusion and intravenous drug users confirmed medically the infectious agent had nothing to do with sexual orientation.
All three of the California cannabis buyers’ clubs, organizations that provide medical marijuana to patients, reported that more than 60 percent of their members requested marijuana for AIDS treatment. In the US, AIDS patients are the largest portion of medical marijuana users.
Personal accounts are effective qualitative data, but not quantitative data. Quantitative data is valued in medical and science communities–with valid reason. If someone says only 2% of users of a certain medicine experience a side effect, that specificity is required. However, numbers aren’t the base of emotion; human stories evoke emotion. Take these accounts as anecdotal but, as a result, personal.
The IOM team, when gathering data for the California cannabis buyers’ club, transcribed personal accounts of AIDS patients who turned to medical marijuana for relief. They cite the a 41-year-old Virginia theater technician told them:
“Thirteen years ago I found out that I was HIV-positive. Since then I have taken AZT, ddI, d4T, Crixivan, Viracept, Viramune, Bactrim, Megace, and others. All these drugs have two things in common: they gave me hope and they also made me sick. Nausea, diarrhea, fatigue, vomiting, and loss of appetite became a way of life for me.
After three years of these side effects ruling my life, a doctor suggested a simple and effective way to deal with many of them. This remedy kept me from slowly starving to death, as I had seen many of my friends do. It helped me rejoin the human race as a responsible, productive citizen. It also made me a criminal, something I have never been before. This remedy, of course, is medical marijuana.”
Numbers of AIDS patients using medical marijuana, and self-medicating, are on the increase. This is particularly true for patients on highly effective antiviral drugs called protease inhibitors. Most suffer from loss of appetite, nausea, vomiting, much like cancer patient’s response to chemotherapy. Most research on the anti-nausea effect of cannabis has focused on chemotherapy-induced nausea and vomiting (CINV).
How Effective Is Medical Marijuana for HIV Patients
There is reason to believe using cannabinoids, particularly medical cannabis, on both Cancer and AIDS patients would be effective, by the level of efficacy is yet to be formally tested. Some studies say medical marijuana is more effective than traditional anti-emetics. However, other studies say other antiemetics are more effective than THC. The scientific data is currently inconclusive.
Considering many factors can lead to nausea and vomiting and each person responds to antiemetics differently, it is possible certain patients would get better treatment with marijuana-based treatments than traditional treatments. This remains to be substantiated by controlled studies however.
We do know, however, people with AIDS who take chemically engineered THC in the form of dronabinol (Marinol) to combat weight loss also find it reduces nausea. During a four week clinical study, AIDS patients who used the drug showed a trend toward decreased nausea compared with patients who took the placebo, as well as a significant appetite increase.
Although nausea and appetite influence wasting, the latter is the primary reason AIDS patients use Marinol. Weight loss is one of two reasons the U.S. Food and Drug Administration approved the drug for sale. The other is nausea and vomiting associated with chemotherapy (anti-cancer treatment). For HIV patients, weight loss as minimal as 5 percent can be life-threatening. Death from wasting usually occurs when a patient’s weight decreases more than one-third below their ideal weight.
The CDC (Centers for Disease Control and Prevention) defines AIDS wasting syndrome as the loss of more than 10 percent of body weight, with diarrhea or fever that lasts more than 30 days. It must be involuntary and not attributable to other illnesses.
Wasting occurs through cachexia and starvation. Cachexia happens through tissue injury and causes a large loss of lean tissue mass, like muscle or liver. Starvation, on the other hand, happens through the deprivation of food and nutrients. It causes a loss of body fat before cachexia depletes lean tissues. Cachexia requires management of the AIDS and medical stimulation of the patient’s metabolism.
Starvation can be cured, in this case, with raising the appetite and eating. Though, in later phases of HIV, infections of ulcers in the mouth, throat, or esophagus can make eating challenging. Other infections cause diarrhea and there is common overgrowth of the microbes that naturally exist within the digestive tract, which both reduce the absorption of nutrients. Depression, fatigue, and poverty can also add to malnutrition in AIDS patients.
Currently, the only cannabinoid evaluated in the clinic for stimulating appetite in AIDS patients has been THC. Though, we are currently unable to confirm if medical marijuana, THC or otherwise, would be able to increase lean muscle mass and fight cachexia. It may just increase bodily fat percentage.
In six-week-long studies and year-long studies, patients who received Marinol, a mimic of THC, tended to have an increased appetite while staying at a stable weight. Five patients actually gained 1 percent of body fat after using Marinol for five weeks.
When taken in pill form, THC is slower to act and clear from the patient’s body. Marinol has a long list of side effects, including headaches, vision problems, dizziness, feeling light-headed, fainting, irritability, nervousness, restlessness, nausea, vomiting, abdominal pain, or a fast heartbeat. It may also increase risk of seizures.
These side effects do not hold true with natural cannabis, but all synthetic cannabis has a similar list of side effects. For these reasons, some AIDS patients–and cancer patients– that they prefer smoking marijuana to swallowing synthetic THC. They also say smoking allows them to inhale the exact right amount to relieve their symptoms.
In May 2000, the first controlled study on the short-term safety of smoked marijuana in HIV patients. It was orchestrated by Donald Abrams, a medical research at the University of California San Francisco. The results showed there say no increase in the HIV virus, in the patients who smoked marijuana, during the 21-day study period.
Although smoking is very effective at getting active chemicals of marijuana quickly into the bloodstream, the long-term lung and throat damage makes it s a poor method of drug delivery, particularly for chronically ill patients, such as those with HIV or HIV AIDS. As stated, however, oral pharmaceutical cannabinoids are slow acting and impossible to individually and properly dose.
A safe method that also appeases patients could be a smokeless inhaler or easily absorbed aerosol spray. Such devices already exist and are used for antihistamines and asthma medicine. There have also been tests using cannabinoid-based skin serums and patches. These would allow AIDS patients to benefit from marijuana without creating other health complications.
Even if studies show that marijuana cannot reverse cachexia, it could potentially be helpful in a combination treatment. If marijuana addresses appetite, nausea, and mood while HIV and HIV AIDS patients undergo physical therapy or take medications for increasing lean tissue mass in their body, they could find an effective middle ground.
Given marijuana has higher tolerability, but cannot be mixed with all prescription drugs, healthcare professionals would be best able to decide on an effective mixture of treatments for their individual patients.
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