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. 2018 Sep 23:2018:9430953.
doi: 10.1155/2018/9430953. eCollection 2018.

Reduced Incidence and Better Liver Disease Outcomes among Chronic HCV Infected Patients Who Consume Cannabis

Adeyinka Charles Adejumo  1   2   3 , Oluwole Muyiwa Adegbala  4 , Kelechi Lauretta Adejumo  3 , Terence Ndonyi Bukong  2   5
Affiliations

Reduced Incidence and Better Liver Disease Outcomes among Chronic HCV Infected Patients Who Consume Cannabis

Adeyinka Charles Adejumo et al. Can J Gastroenterol Hepatol. .

Abstract

Background and aim: The effect of cannabis use on chronic liver disease (CLD) from Hepatitis C Virus (HCV) infection, the most common cause of CLD, has been controversial. Here, we investigated the impact of cannabis use on the prevalence of CLD among HCV infected individuals.

Methods: We analyzed hospital discharge records of adults (age ≥ 18 years) with a positive HCV diagnosis. We evaluated records from 2007 to 2014 of the Nationwide Inpatient Sample (NIS). We excluded records with other causes of chronic liver diseases (alcohol, hemochromatosis, NAFLD, PBC, HBV, etc.). Of the 188,333 records, we matched cannabis users to nonusers on 1:1 ratio (4,728:4,728), using a propensity-based matching system, with a stringent algorithm. We then used conditional regression models with generalized estimating equations to measure the adjusted prevalence rate ratio (aPRR) for having liver cirrhosis (and its complications), carcinoma, mortality, discharge disposition, and the adjusted mean ratio (aMR) of total hospital cost and length of stay (LOS) [SAS 9.4].

Results: Our study revealed that cannabis users (CUs) had decreased prevalence of liver cirrhosis (aPRR: 0.81[0.72-0.91]), unfavorable discharge disposition (0.87[0.78-0.96]), and lower total health care cost ($39,642[36,220-43,387] versus $45,566[$42,244-$49,150]), compared to noncannabis users (NCUs). However, there was no difference among CUs and NCUs on the incidence of liver carcinoma (0.79[0.55-1.13]), in-hospital mortality (0.84[0.60-1.17]), and LOS (5.58[5.10-6.09] versus 5.66[5.25-6.01]). Among CUs, dependent cannabis use was associated with lower prevalence of liver cirrhosis, compared to nondependent use (0.62[0.41-0.93]).

Conclusions: Our findings suggest that cannabis use is associated with decreased incidence of liver cirrhosis, but no change in mortality nor LOS among HCV patients. These novel observations warrant further molecular mechanistic studies.

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Figures

Figure 1
Figure 1
Selection flow chart of study populations. Illustrative flow chart of how our study population was grouped for statistical analysis to determine the impact and disease outcomes among HCV infected individuals who use cannabis.
Figure 2
Figure 2
Summary schematic of the effects of cannabis use by HCV infected individuals and liver disease associated parameters. Our observations suggest that cannabis use by HCV infected individuals is associated with significant reduction in adverse progressive disease associated pathologies. Further, cannabis users had an overall lower cost of disease management compared to noncannabis users. Schematic illustrations made use of some motifolio templates (http://www.motifolio.com/).
See this image and copyright information in PMC

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