Steatosis is highly prevalent in patients with chronic Hepatitis C, and has been reported to increase fibrosis and reduce the rate of viral eradication.
There are 2 recent studies that indicate that endocannabinoids promote experimental steatosis via activation of hepatic CB1 receptors.
Dr Christophe Hézode and colleagues from France therefore investigated the impact of cannabis smoking on steatosis severity during chronic Hepatitis C.
The team included a total of 315 consecutive patients with untreated chronic Hepatitis C undergoing liver biopsy.
Detailed histories of recent cannabis, alcohol, and tobacco use were recorded.
The team assessed steatosis, activity, and fibrosis stage by 2 pathologists according to METAVIR.
|The researchers identified 6 predictors of marked steatosis|
Marked steatosis was defined as 30%.
Patients were categorized as cannabis nonusers, occasional cannabis smokers, or daily cannabis smokers.
The researchers used multivariate analysis, and identified 6 predictors of marked steatosis.
Daily cannabis use, activity grade A2, genotype 3, hyperglycemia or diabetes predicted marked steatosis.
The team noted that a body mass index over 27 kg/m2, and serum Hepatitis C virus RNA load also predicted marked steatosis.
After adjustment of Hepatitis C virus genotype or alcohol intake, the team noted that marked steatosis was more frequent in daily cannabis users vs occasional users and nonusers.
Dr Hézode's team concluded, "Our results identify daily cannabis smoking as a novel independent predictor of steatosis severity during chronic Hepatitis C, and strongly argue for a steatogenic role of the cannabinoid system."
"Cannabis use should be discouraged in patients with chronic Hepatitis C."