The Combined Effects of Cannabis, Methamphetamine, and HIV on Neurocognition
, Erin E. Morgan 2, Mariana Cherner 2, Ronald J. Ellis 2,4, Scott L. Letendre 2,5, Robert K. Heaton 2 and Igor Grant 2Round 1
Reviewer 1 Report
Rogers et al., examined the combinatorial effects of methamphetamine and cannabis in people living with HIV (PLWH) and explored whether these two substances of abuse interacted with HIV status. These studies are important and relevant since both meth and cannabis are commonly used by PLWH, yet their combined effects have not been extensively investigated. The hypothesis is clear, results are well presented and discussed with relevant literature citations. Limitations of the study are also discussed. Minor comments are as follows:
-On page 3, line 126 and on page 5, line 213, a manuscript under review is cited. Please update.
-In the legend for Figure 1, change PWH to PLWH.
Author Response
-On page 3, line 126 and on page 5, line 213, a manuscript under review is cited. Please update.
This manuscript is still under peer review, but we will update the reference as soon as we’re able!
-In the legend for Figure 1, change PWH to PLWH.
Thank you! We have made the correction.
Reviewer 2 Report
This a cross-sectional analysis of methamphetamine and cannabis use on neurocognition in persons living with HIV in the US.
Substance use measures, neurocognitive performance, and statistical analyses are well described in the methods as are the inclusion/exclusion criteria. The results and discussion are well written and suggest a neuroprotective effect of cannabis use in persons with HIV and methamphetamine use. Overall, this is a very rigorous analysis of an important drug use data set.
Several minor clarifications / updates would strengthen then manuscript further, including:
1. The sample type tested for HBc/HIV/HCV antibody should be stated explicitly.
2. The authors mentioned that the rapid vertical flow HBc/HIV/HCV antibody test was performed; however, no details on HBc status are provided.
3. Was the PCR kit standardized for the detection of HIV from CSF? Is the LLQ the same for plasma and CSF?
4. Is there a significant difference between M-C- with M-C+ with respect to HIV viral load or the HIV detectable range?
5. Does methamphetamine usage alone have any significant impact on HIV viral load?
6. What is the impact of HCV – if any – on neurocognitive domain impairment?
7. Author should add references on the effects of methamphetamine or cannabis use in HCV positive individuals with neurocognitive impairment.
8. The authors should elaborate on the effects of cannabis with other substances in HIV induced neurocognitive impairment.
Author Response
Please see attachment
Author Response File: 
Author Response.pdf
