Cannabis use by people with HIV is associated with an anti-inflammatory immunometabolic phenotype in monocyte-derived macrophages.
Journal of neuroinflammation April 17, 2026 Mary K Ford, Peter W Halcrow, Anna E Laird et al.
Daily cannabis use in people with HIV on antiretroviral therapy was associated with less global neurocognitive deficits and with an anti-inflammatory immunometabolic phenotype in monocyte-derived macrophages. This phenotype included a metabolic shift from glycolysis to oxidative phosphorylation, higher mitochondrial numbers, altered cytokine profiles (pro-inflammatory downregulation, anti-inflammatory upregulation), and higher brain-derived neurotrophic factor expression. Plasma biomarkers in daily cannabis users with HIV showed lower levels of growth differentiation factor 15 and soluble triggering receptor expressed on myeloid cells 2, and higher mature BDNF/precursor BDNF ratios that correlated with better cognition. Cannabis use may mitigate neurocognitive impairment by immunometabolically reprogramming macrophage function towards an anti-inflammatory and neuroprotective state.