Daily cannabis and reduced risk of steatosis in human immunodeficiency virus and hepatitis C virus-co-infected patients (ANRS CO13-HEPAVIH)

J Viral Hepat. 2018 Feb;25(2):171-179. doi: 10.1111/jvh.12797. Epub 2017 Nov 20.


Liver steatosis is common in human immunodeficiency virus (HIV)-hepatitis C virus (HCV)-co-infected patients. Some recent studies have found that cannabis use is negatively associated with insulin resistance in the general population and in HIV-HCV-co-infected patients. Given the causal link between insulin resistance and steatosis, we hypothesized that cannabis use has a positive impact on steatosis. Therefore, we aimed to study whether cannabis use in this population was associated with a reduced risk of steatosis, measured by ultrasound examination. ANRS CO13-HEPAVIH is a French nationwide multicentre cohort of HIV-HCV-co-infected patients. Medical and socio-behavioural data from clinical follow-up visits and annual self-administered questionnaires were prospectively collected. A cross-sectional analysis was conducted using data from the first visit where both ultrasound examination data for steatosis (positive or negative diagnosis) and data on cannabis use were available. A logistic regression model was used to evaluate the association between cannabis use and steatosis. Among study sample patients (n = 838), 40.1% had steatosis. Fourteen per cent reported daily cannabis use, 11.7% regular use and 74.7% no use or occasional use ("never or sometimes"). Daily cannabis use was independently associated with a reduced prevalence of steatosis (adjusted odds ratio [95% CI] = 0.64 [0.42;0.99]; P = .046), after adjusting for body mass index, hazardous alcohol consumption and current or lifetime use of lamivudine/zidovudine. Daily cannabis use may be a protective factor against steatosis in HIV-HCV-co-infected patients. These findings confirm the need for a clinical evaluation of cannabis-based pharmacotherapies in this population. Eudract.ema.europa.eu number, DGS050367.

Keywords: hepatitis C virus; human immunodeficiency virus; marijuana; steatosis.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Coinfection / complications
  • Coinfection / virology*
  • Cross-Sectional Studies
  • Fatty Liver / diagnostic imaging
  • Fatty Liver / epidemiology*
  • Fatty Liver / virology
  • Female
  • France / epidemiology
  • HIV Infections / complications*
  • HIV Infections / virology
  • Hepacivirus / drug effects
  • Hepatitis C / complications*
  • Hepatitis C / virology
  • Humans
  • Insulin Resistance
  • Liver / diagnostic imaging
  • Liver / pathology
  • Logistic Models
  • Male
  • Marijuana Smoking / adverse effects*
  • Marijuana Smoking / epidemiology
  • Middle Aged
  • Prospective Studies
  • Risk Factors
  • Surveys and Questionnaires
  • Ultrasonography / methods