Influence of cannabis use on severity of hepatitis C disease
Influence of cannabis use on severity of hepatitis C disease
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DOI：
10.1016/j.cgh.2007.10.021
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发表时间：
2008-01-01
影响因子：
12.6
通讯作者：
Terraidt, N. A.
中科院分区：
文献类型：
--
作者：
Ishida, J. H.;Peters, M. G.;Terraidt, N. A.
背景与目的丙型肝炎病毒感染的并发症主要与晚期纤维化的发展有关，而大麻的使用是否是更严重的纤维化的危险因素存在争议。方法采用204例慢性丙型肝炎病毒感染者的前瞻性队列研究的基线数据进行分析。结果队列的中位年龄为46.8岁，男性69.1%，白人49.0%，推测感染途径为注射吸毒占70.1%。一生饮酒时间的中位数为29.1年，平均每天饮酒当量为1.94。大麻使用频率(前12个月内)为每天13.7%，偶尔45.1%，从不使用41.2%。按Ishak方法评估，纤维化分期分别为F0、F1-2和F3-6的受试者分别为27.5%、55.4%和17.2%。在单变量(优势比[OR]，3.21；95%可信区间[CI]，1.20-8.56，P=.020)和多因素分析(优势比，6.78；95%可信区间，1.89-24.31，P=.003)中，每日吸食大麻与不每日吸食大麻显著相关(F3-6vsF1-2)。F3-6的其他独立预测因素是丙型肝炎病毒11门管区(与之相比，OR为6.92；95%CI，1.34-35.7，P=.021)和终生饮酒时间(每十年OR为1.72；95%CI，1.02-2.90，P=.044)。结论每日吸食大麻与中度至重度肝纤维化密切相关，应建议≥感染者减少或戒除吸食大麻。
Background & AimsComplications of HCV infection are primarily related to the development of advanced fibrosis and whether cannabis use is a risk factor for more severe fibrosis is controversial.MethodsBaseline data from a prospective cohort study of 204 persons with chronic HCV infection were used for analysis. The outcome was fibrosis score on biopsy, and the primary predictor evaluated was daily cannabis use.ResultsThe median age of the cohort was 46.8 years, 69.1% were male, 49.0% were white, and the presumed route of infection was injection drug use in 70.1%. The median lifetime duration and average daily use of alcohol were 29.1 years and 1.94 drink equivalents per day, respectively. Cannabis use frequency (within prior 12 months) was daily in 13.7%, occasional in 45.1%, and never in 41.2%. Fibrosis stage, assessed by the Ishak method, was F0, F1–2, and F3–6 in 27.5%, 55.4%, and 17.2% of subjects, respectively. Daily compared with non-daily cannabis use was significantly associated with moderate to severe fibrosis (F3–6 vs F1–2) in univariate (odds ratio [OR], 3.21; 95% confidence interval [CI], 1.20–8.56, P = .020) and multivariate analyses (OR, 6.78; 95% CI, 1.89–24.31, P = .003). Other independent predictors of F3–6 were ≥11 portal tracts (compared with <5, OR, 6.92; 95% CI, 1.34–35.7, P = .021) and lifetime duration of moderate to heavy alcohol use (OR per decade, 1.72; 95% CI, 1.02–2.90, P = .044).ConclusionsDaily cannabis use is strongly associated with moderate to severe fibrosis, and HCV-infected individuals should be counseled to reduce or abstain from cannabis use.