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Journal of Hepatology
Volume 48, Issue 4, April 2008, Pages 657-665

Environmental factors as disease accelerators during chronic hepatitis C

Ariane Mallat, a, b, c, , Christophe Hezodea, b, c and Sophie Lotersztajna,
b, c

A Department of Hepatology and Gastroenterology, INSERM U841, Groupe
hospitalier Henri Mondor-Albert Chenevier, Créteil F-94000, France
B AP-HP, Groupe hospitalier Henri Mondor-Albert Chenevier, Service
d’Hépatologie et de Gastroentérologie, Créteil F-94000, France
C Université Paris 12, Faculté de Médecine, Créteil F-94000, France

Corresponding author.
Tel.: +33 (0) 1 49 81 23 67;
fax: +33 (0) 1 49 81 23 52.

Keywords: Alcohol; Tobacco; Hepatitis C virus; Chronic hepatitis C;
Cannabis; CB1 receptor; CB2 receptor; Cannabinoid

Progression of chronic hepatitis is highly variable among individuals, as
the result of several host, viral and environmental factors.
The latter have been extensively investigated in order to ameliorate
hepatitis C outcome, particularly in difficult-to-treat patients.
Over the last decade, several studies have shown that a combination of HCV
infection and high levels of alcohol abuse results in synergistic
acceleration of liver fibrogenesis.
In addition, recent data indicate that light alcohol intake may also
exacerbate fibrosis progression.
It has also been suggested that cigarette smoking may enhance activity grade
in patients with chronic hepatitis C, thereby increasing progression of
This assumption mostly relies on epidemiological evidences in the absence of
pathogenic studies.
Finally, cannabis use is increasingly emerging as a novel co-morbidity in
patients with chronic hepatitis C.
Indeed, regular cannabis smoking is an independent predictor of both
fibrosis and steatosis severity in infected patients.
In addition, experimental studies have shown that cannabinoid CB1 receptors
enhance liver fibrogenesis and steatogenesis by distinct mechanisms,
therefore strongly supporting epidemiological findings.
Altogether, patients should be informed of the deleterious impact of
alcohol, tobacco and cannabis use and should be offered appropriate support
to achieve abstinence.

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190885 tn?1333029491
i don't know about the post but your profile cracked me up......i think a little pot isn't that bad...what about other pollution like from cars ..carpets...coal plants...bad water supply..and bombs....billy
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