Aa
does pot hurt your liver?
Does pot hurt your liver in the same way alchohol does?? My 22 year old daughter is schuduled to start tx next month in the telaprivir phase III trial. She also has a beach house for the summer. Since summer beach house and 22 year olds have a lot in common with alchohol consumption, she was reluctant to join the trial, but of course she made the right decision and has joined the trial and sworn off alcholol. I am making an assumption that in leiu of alchohol, she may in fact partake in some reefer madness while at the beach house and I wasn't all that concerned (that doesn't make me sound like Donna Read, but I am a pragmatic women). Then I read in a post from someone who compiled a list of rescue drug interactions and saw the comment that both pot and alchohol could cause liver damage. I had never heard that. Can someone clarify further for me? Also, if anyone has any words of wisdom for us regarding teleprivri (if she is lucky enough to get it v. the placebo) I would welcome them. I know the effects of peg/ribo treatment already - I am a relapser after 48 wks of tx, but don't know about the teleprivir. Long post, sorry!
Thank you for posting these so that those with an interest can see where you misquoted/misinterpreted results. Especially interesting is the study with 7x figure - daily use and use with alcohol - things already covered in this thread.
And almost 40% of the study subjects coinfected with HIV - that never skewed the results of any study.
And almost 40% of the study subjects coinfected with HIV - that never skewed the results of any study.
merryBe: You keep saying that pot use increases fibrosis 7x but you don't qualify that. That's for daily use. The poster who asked this question was asking what's the damage to a young woman who might take the occasional hit with friends. Your answer is misleading to answer the poster's question by saying her daughter's fibrosis would increase by 7X.
Indeed, unless every person who's asking that question is a daily pot smoker, and we haven't qualified yet if that's one joint (don't know the current vernacular for that) a day or more, then your stock answer of 7X increase to fibrosis for ANYONE who smokes pot continues to be misleading.
Based on the study you posted, which I also posted the last time you gave this 7X answer without qualifying it, you should be answering that question from now on by saying that studies show that fibrosis increases by 7X for daily pot smokers.
Despite this study, doctors continue to condone the use of medical marijuana for persons on treatment for HCV to help them deal with the side effects when that is the most effective means of dealing with the side effects. Even the study you're quoting here stops short of recommending that pot be avoided .. it only goes as far as saying persons with HCV should reduce pot usage or abstain.
Indeed, unless every person who's asking that question is a daily pot smoker, and we haven't qualified yet if that's one joint (don't know the current vernacular for that) a day or more, then your stock answer of 7X increase to fibrosis for ANYONE who smokes pot continues to be misleading.
Based on the study you posted, which I also posted the last time you gave this 7X answer without qualifying it, you should be answering that question from now on by saying that studies show that fibrosis increases by 7X for daily pot smokers.
Despite this study, doctors continue to condone the use of medical marijuana for persons on treatment for HCV to help them deal with the side effects when that is the most effective means of dealing with the side effects. Even the study you're quoting here stops short of recommending that pot be avoided .. it only goes as far as saying persons with HCV should reduce pot usage or abstain.
Gastroenterology. 2008 Feb;134(2):622-5.
Daily cannabis use: a novel risk factor of steatosis severity in patients with chronic hepatitis C.Hézode C, Zafrani ES, Roudot-Thoraval F, Costentin C, Hessami A, Bouvier-Alias M, Medkour F, Pawlostky JM, Lotersztajn S, Mallat A.
Department of Hepatology and Gastroenterology, Groupe Hospitalier Henri Mondor-Albert Chenevier, Créteil, France.
BACKGROUND & AIMS: Steatosis is highly prevalent in patients with chronic hepatitis C (CHC) and has been reported to increase fibrosis and reduce the rate of viral eradication. Two recent studies indicate that endocannabinoids promote experimental steatosis via activation of hepatic CB1 receptors. We therefore investigated the impact of cannabis smoking on steatosis severity during CHC. METHODS: A total of 315 consecutive patients with untreated CHC undergoing liver biopsy were included. Detailed histories of recent cannabis, alcohol, and tobacco use were recorded. Steatosis, activity, and fibrosis stage were assessed by 2 pathologists according to METAVIR. Marked steatosis was defined as >/=30%. Patients were categorized as cannabis nonusers (63.5%), occasional cannabis smokers (12.4%), or daily cannabis smokers (24.1%). RESULTS: Multivariate analysis identified 6 predictors of marked steatosis: daily cannabis use (odds ratio [OR], 2.1; 95% confidence interval [CI], 1.01-4.5]), activity grade >/=A2 (OR, 2.1; 95% CI, 1.0-4.3), genotype 3 (OR, 5.4; 95% CI, 2.6-11.3), hyperglycemia or diabetes (OR, 5.1; 95% CI, 1.8-15.0), body mass index >27 kg/m(2) (OR, 2.1; 95% CI, 1.0-4.3), and serum HCV RNA load (OR, 1.7; 95% CI, 1.0-2.9). Upon adjustment of HCV genotype (3 vs non-3) or alcohol intake (/=30 g/day), marked steatosis was more frequent in daily cannabis users compared with occasional users and nonusers (P = .03 and P = .008, respectively). CONCLUSIONS: Our results identify daily cannabis smoking as a novel independent predictor of steatosis severity during CHC and strongly argue for a steatogenic role of the cannabinoid system. Cannabis use should be discouraged in patients with CHC.
Daily cannabis use: a novel risk factor of steatosis severity in patients with chronic hepatitis C.Hézode C, Zafrani ES, Roudot-Thoraval F, Costentin C, Hessami A, Bouvier-Alias M, Medkour F, Pawlostky JM, Lotersztajn S, Mallat A.
Department of Hepatology and Gastroenterology, Groupe Hospitalier Henri Mondor-Albert Chenevier, Créteil, France.
BACKGROUND & AIMS: Steatosis is highly prevalent in patients with chronic hepatitis C (CHC) and has been reported to increase fibrosis and reduce the rate of viral eradication. Two recent studies indicate that endocannabinoids promote experimental steatosis via activation of hepatic CB1 receptors. We therefore investigated the impact of cannabis smoking on steatosis severity during CHC. METHODS: A total of 315 consecutive patients with untreated CHC undergoing liver biopsy were included. Detailed histories of recent cannabis, alcohol, and tobacco use were recorded. Steatosis, activity, and fibrosis stage were assessed by 2 pathologists according to METAVIR. Marked steatosis was defined as >/=30%. Patients were categorized as cannabis nonusers (63.5%), occasional cannabis smokers (12.4%), or daily cannabis smokers (24.1%). RESULTS: Multivariate analysis identified 6 predictors of marked steatosis: daily cannabis use (odds ratio [OR], 2.1; 95% confidence interval [CI], 1.01-4.5]), activity grade >/=A2 (OR, 2.1; 95% CI, 1.0-4.3), genotype 3 (OR, 5.4; 95% CI, 2.6-11.3), hyperglycemia or diabetes (OR, 5.1; 95% CI, 1.8-15.0), body mass index >27 kg/m(2) (OR, 2.1; 95% CI, 1.0-4.3), and serum HCV RNA load (OR, 1.7; 95% CI, 1.0-2.9). Upon adjustment of HCV genotype (3 vs non-3) or alcohol intake (/=30 g/day), marked steatosis was more frequent in daily cannabis users compared with occasional users and nonusers (P = .03 and P = .008, respectively). CONCLUSIONS: Our results identify daily cannabis smoking as a novel independent predictor of steatosis severity during CHC and strongly argue for a steatogenic role of the cannabinoid system. Cannabis use should be discouraged in patients with CHC.
Influence of cannabis use on severity of hepatitis C disease.Ishida JH, Peters MG, Jin C, Louie K, Tan V, Bacchetti P, Terrault NA.
Department of Medicine, University of California at San Francisco, San Francisco, California, USA.
BACKGROUND & AIMS: Complications 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. METHODS: Baseline 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. RESULTS: The 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 >or=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). CONCLUSIONS: Daily cannabis use is strongly associated with moderate to severe fibrosis, and HCV-infected individuals should be counseled to reduce or abstain from cannabis use.
Department of Medicine, University of California at San Francisco, San Francisco, California, USA.
BACKGROUND & AIMS: Complications 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. METHODS: Baseline 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. RESULTS: The 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 >or=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). CONCLUSIONS: Daily cannabis use is strongly associated with moderate to severe fibrosis, and HCV-infected individuals should be counseled to reduce or abstain from cannabis use.
Marijuana Increases Risk of Hepatitis C-Related Liver Damage
02/03/2008
BETHESDA, Md. – Patients with chronic hepatitis C virus (HCV) infection should not use marijuana (cannabis) daily, according to a study published in Clinical Gastroenterology and Hepatology, the official journal of the American Gastroenterological Association (AGA) Institute. Researchers found that HCV patients who used cannabis daily were at significantly higher risk of moderate to severe liver fibrosis, or tissue scarring. Additionally, patients with moderate to heavy alcohol use combined with regular cannabis use experienced an even greater risk of liver fibrosis. The recommendation to avoid cannabis is especially important in patients who are coinfected with HCV/HIV, since the progression of fibrosis is already greater in these patients.
"Hepatitis C is a major public health concern and the number of patients developing complications of chronic disease is on the rise," according to Norah Terrault, MD, MPH, from the University of California, San Francisco, and lead investigator of the study. "It is essential that we identify risk factors that can be modified to prevent and/or lessen the progression of HCV to fibrosis, cirrhosis and even liver cancer. These complications of chronic HCV infection will significantly contribute to the overall burden of liver disease in the U.S. and will continue to increase in the next decade."
This is the first study that evaluates the relationship between alcohol and cannabis use in patients with HCV and those coinfected with HCV/HIV. It is of great importance to disease management that physicians understand the factors influencing HCV disease severity, especially those that are potentially modifiable. The use and abuse of both alcohol and marijuana together is not an uncommon behavior. Also, individuals who are moderate and heavy users of alcohol may use cannabis as a substitute to reduce their alcohol intake, especially after receiving a diagnosis like HCV, which affects their liver.
Researchers found a significant association between daily versus non-daily cannabis use and moderate to severe fibrosis when reviewing this factor alone. Other factors contributing to increased fibrosis included age at enrollment, lifetime duration of alcohol use, lifetime duration of moderate to heavy alcohol use and necroinflammatory score (stage of fibrosis). In reviewing combined factors, there was a strong (nearly seven-fold higher risk) and independent relationship between daily cannabis use and moderate to severe fibrosis. Gender, race, body mass index, HCV viral load and genotype, HIV coinfection, source of HCV infection, and biopsy length were not significantly associated with moderate to severe fibrosis.
Of the 328 patients screened for the study, 204 patients were included in the analysis. The baseline characteristics of those included in the study were similar to those excluded with the exception of daily cannabis use (13.7 percent of those studied used cannabis daily versus 6.45 percent of those not included). Patients who used cannabis daily had a significantly lower body mass index than non-daily users (25.2 versus 26.4), were more likely to be using medically prescribed cannabis (57.1 percent versus 8.79 percent), and more likely to have HIV coinfection (39.3 percent versus 18.2 percent).
The prevalence of cannabis use amongst adults in the U.S. is estimated to be almost 4 percent. Regular use has increased in certain population subgroups, including those aged 18 to 29.
Source: American Gastroenterological Association
02/03/2008
BETHESDA, Md. – Patients with chronic hepatitis C virus (HCV) infection should not use marijuana (cannabis) daily, according to a study published in Clinical Gastroenterology and Hepatology, the official journal of the American Gastroenterological Association (AGA) Institute. Researchers found that HCV patients who used cannabis daily were at significantly higher risk of moderate to severe liver fibrosis, or tissue scarring. Additionally, patients with moderate to heavy alcohol use combined with regular cannabis use experienced an even greater risk of liver fibrosis. The recommendation to avoid cannabis is especially important in patients who are coinfected with HCV/HIV, since the progression of fibrosis is already greater in these patients.
"Hepatitis C is a major public health concern and the number of patients developing complications of chronic disease is on the rise," according to Norah Terrault, MD, MPH, from the University of California, San Francisco, and lead investigator of the study. "It is essential that we identify risk factors that can be modified to prevent and/or lessen the progression of HCV to fibrosis, cirrhosis and even liver cancer. These complications of chronic HCV infection will significantly contribute to the overall burden of liver disease in the U.S. and will continue to increase in the next decade."
This is the first study that evaluates the relationship between alcohol and cannabis use in patients with HCV and those coinfected with HCV/HIV. It is of great importance to disease management that physicians understand the factors influencing HCV disease severity, especially those that are potentially modifiable. The use and abuse of both alcohol and marijuana together is not an uncommon behavior. Also, individuals who are moderate and heavy users of alcohol may use cannabis as a substitute to reduce their alcohol intake, especially after receiving a diagnosis like HCV, which affects their liver.
Researchers found a significant association between daily versus non-daily cannabis use and moderate to severe fibrosis when reviewing this factor alone. Other factors contributing to increased fibrosis included age at enrollment, lifetime duration of alcohol use, lifetime duration of moderate to heavy alcohol use and necroinflammatory score (stage of fibrosis). In reviewing combined factors, there was a strong (nearly seven-fold higher risk) and independent relationship between daily cannabis use and moderate to severe fibrosis. Gender, race, body mass index, HCV viral load and genotype, HIV coinfection, source of HCV infection, and biopsy length were not significantly associated with moderate to severe fibrosis.
Of the 328 patients screened for the study, 204 patients were included in the analysis. The baseline characteristics of those included in the study were similar to those excluded with the exception of daily cannabis use (13.7 percent of those studied used cannabis daily versus 6.45 percent of those not included). Patients who used cannabis daily had a significantly lower body mass index than non-daily users (25.2 versus 26.4), were more likely to be using medically prescribed cannabis (57.1 percent versus 8.79 percent), and more likely to have HIV coinfection (39.3 percent versus 18.2 percent).
The prevalence of cannabis use amongst adults in the U.S. is estimated to be almost 4 percent. Regular use has increased in certain population subgroups, including those aged 18 to 29.
Source: American Gastroenterological Association
until you get to a certain stage of this disease, your body may be able to keep up with reversals of damage. Example: say you are very athletic, you may produce more HGH than average, in this case your liver may turn over every cell in one years time...
the average time for entire organ turnover is 1 1/2 years...meaning the liver is an amazing healer as long as the pituitary and bone marrow do their jobs.
However at some point the rate of damage is going to far exceed the rate of repair an aging body can perform at...and at that point the downhill curve can be quite steep.
Example: even in non HCV female drinkers the curve from stage one to stage 3 looks snail paced compared to the time it takes to go from stage 3 to 4, assuming alcohol consumption continues. .
the pot study has been posted in here 15 times..as you well know...
I'll post it again, but I serious doubt the pot smokers will really lend it any credence.
the fact that some folks want to ignore the research, doesn't mean the research isn't valid,
remember that.
mb.
the average time for entire organ turnover is 1 1/2 years...meaning the liver is an amazing healer as long as the pituitary and bone marrow do their jobs.
However at some point the rate of damage is going to far exceed the rate of repair an aging body can perform at...and at that point the downhill curve can be quite steep.
Example: even in non HCV female drinkers the curve from stage one to stage 3 looks snail paced compared to the time it takes to go from stage 3 to 4, assuming alcohol consumption continues. .
the pot study has been posted in here 15 times..as you well know...
I'll post it again, but I serious doubt the pot smokers will really lend it any credence.
the fact that some folks want to ignore the research, doesn't mean the research isn't valid,
remember that.
mb.
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