Internal Medicine Department, Addiction Unit, Hospital Universitari Germans Trias I Pujol, Universitat Autonoma de Barcelona, Badalona, Spain.
Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine/Boston Medical Center, Boston (MA), United States.
Curr HIV Res. 2021;19(4):324-331. doi: 10.2174/1570162X19666210519151320.
This study aimed to analyze the association between any past-month cannabis use and advanced liver fibrosis.
Cannabinoid receptors play a role in acute and chronic liver injury, but human studies addressing the impact of cannabis use on liver fibrosis have shown mixed results.
The objective of this study was to explore and estimate the association between pastmonth cannabis use and advanced liver fibrosis (ALF) in a cohort of Russian HIV-positive individuals with heavy alcohol use and a high prevalence of hepatitis C virus (HCV) coinfection.
Baseline data were analyzed from participants of the ZINC study, a trial that enrolled HIV-positive Russian patients without prior antiretroviral therapy. Cannabis use during the prior month was assessed at study entry. ALF was defined as FIB-4>3.25 and APRI>1.5. Transient elastography was used to detect advanced liver fibrosis among participants with FIB-4 values in the intermediate range (between 1.45 and 3.25).
Participants (n=248) were mostly male (72.6%), young (median age of 33.9 years), infected with HCV (87.9%), and did not have advanced immunosuppression (median CD4 count 465). Cannabis use was uncommon (12.4%), and the prevalence of advanced liver disease was 21.7%. The prevalence of ALF was similar among those who used cannabis compared to those who did not (25.8% vs. 21.7%). We were unable to detect an association between cannabis use and ALF (adjusted odds ratio: 1.28, 95% confidence interval: 0.53-3.12, p=0.59) in logistic regression models adjusting for age, sex, heavy drinking, BMI, and CD4 cell count.
In this exploratory study among HIV-positive heavy drinking Russians, we did not detect an association between recent cannabis use and ALF. Larger scale studies, including more participants with cannabis use, are needed to examine this relationship further.
本研究旨在分析过去一个月内任何大麻使用与晚期肝纤维化之间的关联。
大麻素受体在急性和慢性肝损伤中发挥作用，但人类研究表明，大麻使用对肝纤维化的影响结果不一。
本研究旨在探讨和评估在俄罗斯 HIV 阳性、大量饮酒且丙型肝炎病毒（HCV）合并感染率高的人群中，过去一个月内大麻使用与晚期肝纤维化（ALF）之间的关联。
对 ZINC 研究的参与者进行了基线数据分析，该研究招募了未接受过抗逆转录病毒治疗的俄罗斯 HIV 阳性患者。在研究入组时评估了过去一个月内的大麻使用情况。ALF 定义为 FIB-4>3.25 和 APRI>1.5。对于 FIB-4 值处于中间范围（1.45 至 3.25 之间）的参与者，使用瞬时弹性成像检测晚期肝纤维化。
参与者（n=248）主要为男性（72.6%）、年轻人（中位年龄 33.9 岁）、感染 HCV（87.9%），且免疫抑制程度不严重（中位 CD4 计数 465）。大麻使用不常见（12.4%），晚期肝病的患病率为 21.7%。与未使用大麻者相比，使用大麻者的 ALF 患病率相似（25.8% vs. 21.7%）。我们在调整年龄、性别、大量饮酒、BMI 和 CD4 细胞计数的逻辑回归模型中，未检测到大麻使用与 ALF 之间存在关联（调整后的优势比：1.28，95%置信区间：0.53-3.12，p=0.59）。
在这项针对俄罗斯 HIV 阳性、大量饮酒者的探索性研究中，我们未发现近期大麻使用与 ALF 之间存在关联。需要更大规模的研究，包括更多使用大麻的参与者，以进一步研究这种关系。
