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Lack of Association Between Recent Cannabis Use and Advanced Liver Fibrosis Among HIV-positive Heavy Drinkers

[ Vol. 19 , Issue. 4 ]


Daniel Fuster *, Kaku So-Armah, Debbie M. Cheng , Sharon M. Coleman , Natalia Gnatienko, Dmitry Lioznov, Evgeny M. Krupitsky , Matthew S. Freiberg and Jeffrey H. Samet   Pages 324 - 331 ( 8 )


Aim: This study aimed to analyze the association between any past-month cannabis use and advanced liver fibrosis.

Background: Cannabinoid receptors play a role in acute and chronic liver injury, but human studies addressing the impact of cannabis use on liver fibrosis have shown mixed results.

Objective: The objective of this study was to explore and estimate the association between pastmonth cannabis use and advanced liver fibrosis (ALF) in a cohort of Russian HIV-positive individuals with heavy alcohol use and a high prevalence of hepatitis C virus (HCV) coinfection.

Methods: Baseline data were analyzed from participants of the ZINC study, a trial that enrolled HIV-positive Russian patients without prior antiretroviral therapy. Cannabis use during the prior month was assessed at study entry. ALF was defined as FIB-4>3.25 and APRI>1.5. Transient elastography was used to detect advanced liver fibrosis among participants with FIB-4 values in the intermediate range (between 1.45 and 3.25).

Results: Participants (n=248) were mostly male (72.6%), young (median age of 33.9 years), infected with HCV (87.9%), and did not have advanced immunosuppression (median CD4 count 465). Cannabis use was uncommon (12.4%), and the prevalence of advanced liver disease was 21.7%. The prevalence of ALF was similar among those who used cannabis compared to those who did not (25.8% vs. 21.7%). We were unable to detect an association between cannabis use and ALF (adjusted odds ratio: 1.28, 95% confidence interval: 0.53-3.12, p=0.59) in logistic regression models adjusting for age, sex, heavy drinking, BMI, and CD4 cell count.

Conclusion: In this exploratory study among HIV-positive heavy drinking Russians, we did not detect an association between recent cannabis use and ALF. Larger scale studies, including more participants with cannabis use, are needed to examine this relationship further.


Cannabis, liver fibrosis, alcohol, HIV, HCV, FIB-4.


Internal Medicine Department, Addiction Unit, Hospital Universitari Germans Trias I Pujol, Universitat Autonoma de Barcelona, Badalona, Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine/Boston Medical Center, Boston (MA), Biostatistics Department, Boston University School of Public Health, Boston, MA, Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, MA, Clinical Addiction Research and Education Unit, Department of Medicine, Section of General Internal Medicine, Boston Medical Center, Boston, MA, Department of Infectious Diseases and Epidemiology, First Pavlov State Medical University, St. Petersburg, V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology, St. Petersburg, Cardiovascular Medicine Division, Vanderbilt University Medical Center, Nashville , TN, Department of Community Health Sciences, Boston University School of Public Health, Boston MA

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