Abstract
Background. Marijuana (hereafter "tetrahydrocannabinol [THC]") use has been associated with liver fibrosis progression in retrospective analyses of patients with chronic hepatitis C (HCV). We studied long-term effects of THC on fibrosis progression in women coinfected with human immunodeficiency virus (HIV)/HCV enrolled in the 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-coinfected women followed for a median of 11 (interquartile range, 6-17) years, 324 (56%) reported no THC use, 141 (25%) less than weekly use, 70 (12%) weekly use, and 40 (7%) daily use at WIHS entry. In univariable analysis, entry FIB-4 score (hazard ratio [HR], 2.26 [95% confidence interval {CI}, 1.88-2.73], P <. 001), log HCV RNA (HR, 1.19 [95% CI, 1.02-1.38], P =. 02), tobacco use (HR, 1.37 [95% CI, 1.02-1.85], P =. 04), CD4+ count (risk per 100-cell increase: HR, 0.90 [95% CI,. 86-.95], P <. 001), and log HIV RNA (HR, 1.18 [95% CI, 1.05-1.32], P =. 005) were associated with progression to significant fibrosis, as was cumulative alcohol use in follow-up (HR, 1.03 [95% CI, 1.02-1.04], P <. 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,. 92-1.10], P =. 83). Conclusions. In this large cohort of HIV/HCV-coinfected 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-coinfected women.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 512-518 |
| Number of pages | 7 |
| Journal | Clinical Infectious Diseases |
| Volume | 63 |
| Issue number | 4 |
| DOIs | |
| State | Published - Aug 15 2016 |
Funding
This work was supported by the National Institute of Allergy and Infectious Diseases (NIAID) (award numbers U01-AI- 103401, U01-AI-103408, UO1-AI-35004, UO1-AI-31834, UO1-AI-34994, U01-AI-103397, U01-AI-103390, UO1-AI-34989, and UO1-AI-42590), with additional co-funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the National Cancer Institute (NCI), the National Institute on Drug Abuse (NIDA), and the National Institute of Mental Health (NIMH). Targeted supplemental funding for specific projects is also provided by the National Institute of Dental and Craniofacial Research (NIDCR), the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the National Institute on Deafness and Other Communication Disorders (NIDCD), and the NIH Office of Research on Women's Health. WIHS data collection is also supported by the University of California, San Francisco Clinical and Translational Science Award program (UCSF CTSA) (award number UL1-TR000004) and Atlanta CTSA (award number UL1-TR000454). The study was also supported by the UCSF Liver Center National Institute of Health (award number P30 DK026743) and by the NIAID (award numbers R21 AI088351 to M. G. P., K24 AI 108516 and R01 AI 087176 to P. C. T.), which was administered by the Northern California Institute for Research and Education, and with resources of the Veterans Affairs Medical Center, San Francisco, California. WIHS (Principal Investigators): U01-AI-103408; Bronx WIHS (Kathryn Anastos), U01-AI-035004; Brooklyn WIHS (Howard Minkoff and Deborah Gustafson), U01-AI-031834; Chicago WIHS (Mardge Cohen and Audrey French), U01-AI-034993; Metropolitan Washington WIHS (Mary Young and Seble Kassaye), U01-AI-034994; Connie Wofsy Women's HIV Study, Northern California (Ruth Greenblatt, Bradley Aouizerat, and Phyllis Tien), U01-AI-034989; WIHS Data Management and Analysis Center (Stephen Gange and Elizabeth Golub), U01-AI- 042590; Southern California WIHS (Alexandra Levine and Marek Nowicki), U01-HD-032632 (WIHS I-WIHS IV). The WIHS is funded primarily by the NIAID, with additional co-funding from the NICHD, NCI, NIDA, and NIMH. Targeted supplemental funding for specific projects is also provided by NIDCR, NIAAA, NIDCD, and the NIH Office of Research on Women's Health. WIHS data collection is also supported by UL1- TR000004 (UCSF CTSA)
Keywords
- HCV
- HIV
- Liver fibrosis
- Marijuana
- Women
ASJC Scopus subject areas
- Microbiology (medical)
- Infectious Diseases
