Abstract
BACKGROUND:
Marijuana (THC) use has been associated with liver fibrosis progression in retrospective analyses of chronic hepatitis C (HCV) patients. We studied long-term effects of THC on fibrosis progression in women co-infected with HIV/HCV enrolled in Women’s Interagency HIV Study (WIHS).
METHODS:
Liver fibrosis was categorized according to FIB-4 scores as none, moderate, or significant. THC and alcohol use were quantified as average exposure per week. Associations between THC use and progression to significant fibrosis were assessed using Cox proportional hazards regression.
RESULTS:
Among 575 HIV/HCV co-infected women followed for 11 (6-17) years [median (IQR)], 324 (56%) reported no THC use; 141 (25%) reported less than weekly use; 70 (12%) weekly use; and 40 (7%) daily use at WIHS entry. In univariable analysis, entry FIB-4 [HR 2.26 (1.88-2.73) p<0.001], log HCV RNA [HR 1.19 (1.02-1.38) p=0.02], tobacco use [HR 1.37 (1.02-1.85) p=0.04], CD4+ count [risk per 100 count increase HR 0.90 (0.86-0.95) p<0.001] and log HIV RNA [HR 1.18 (1.05-1.32) p=0.005] were associated with progression to significant fibrosis, as was cumulative alcohol use in follow-up [HR 1.03 (1.02-1.04) p<0.001]. In multivariable analysis, entry FIB-4, entry CD4+ count and cumulative alcohol use remained significant. Cumulative THC use was not associated with fibrosis progression [HR 1.01(95% CI 0.92-1.10) p=0.83].
CONCLUSIONS:
In this large cohort of HIV/HCV co-infected women, THC was not associated with progression to significant liver fibrosis. Alcohol use was independently associated with liver fibrosis, and may better predict fibrosis progression in HIV/HCV co-infected women.
© The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.
- PMID: 27225241
- [PubMed – as supplied by publisher]
