Aa
Pot and fibrosis, HCV
I saw a post on a HCV website about pot and HCV and fibrosis.
Good point!
_________________________________________________
A study came out a little while ago on how higher fibrosis scores were associated with daily cannabis use.
An article apears at
http://www.hivandhepatitis.com/hep_c/news/2008/012508_b.html
and
http://www.hepatitis-central.com/mt/archives/2008/01/risk_of_fibrosi.html?eml=hepcen45
After reading the short write ups I have to ask myself the logical question...
Is it the health problems associated with advanced fibrosis that is causing people to seek relief from cannabis? Or is cannabis use actually CAUSING the fibrosis?
To have an association between 2 sets of data does not necessarily one causes the other!
ie: The researchers found that owners of 3 story homes tend to earn more money than those who rent apartments.
Conclusion: Renting apartments causes lower income.
Alp
Good point!
_________________________________________________
A study came out a little while ago on how higher fibrosis scores were associated with daily cannabis use.
An article apears at
http://www.hivandhepatitis.com/hep_c/news/2008/012508_b.html
and
http://www.hepatitis-central.com/mt/archives/2008/01/risk_of_fibrosi.html?eml=hepcen45
After reading the short write ups I have to ask myself the logical question...
Is it the health problems associated with advanced fibrosis that is causing people to seek relief from cannabis? Or is cannabis use actually CAUSING the fibrosis?
To have an association between 2 sets of data does not necessarily one causes the other!
ie: The researchers found that owners of 3 story homes tend to earn more money than those who rent apartments.
Conclusion: Renting apartments causes lower income.
Alp
Marijuana smoking does not appear to cause progression of liver fibrosis in the Canadian HIV/HCV Co-infection Cohort study APRIL 2012
Authors:Brunet L, Moodie EE, Rollet K, Tyndall M, Potter M, Conway B, Walmsley S, Pick N, Cooper C, Cox J, Klein MB for the
Canadian Co-infection Cohort (CTN222)
Location: 21st Annual Canadian Conference on HIV/AIDS Research (CAHR 2012) Montreal
Background:
The literature on the effect of cannabis on liver diseases is conflicting. Cell cultures and animal model studies conclude that
cannabidiol could have a therapeutic effect on liver injuries. However, cross-sectional studies of chronic HCV patients suggest
that daily cannabis use is associated with fibrosis and steatosis. This study aims at estimating the causal effect of marijuana use
on liver fibrosis progression in the Canadian Co-infection Cohort study.
Methods:
HIV/HCV co-infected individuals were followed-up every six month. At each visit, they provided information on marijuana use
which was then categorized as (1) did not use, (2) used occasionally, (3) used daily, ≤4 joints/day, and (4) used daily, >4 joints/
day, based on the median. To account for time-dependent confounding, marginal structural pooled logistic regression models
were used to assess the effect of marijuana use on progression to significant fibrosis (APRI>=1.5). Baseline (age, sex, ethnicity,
low income, duration of HCV infection) and updated characteristics (CD4 cell count, HIV viral load, antiretroviral therapy,
alcohol use, illicit opioid use and other IDU) were included in the inverse probability of treatment weights calculation.
APRIL 2012
A total of 843 patients contributed 3,914 person-visits and 161 progressed to significant fibrosis. At baseline, 52% had smoked
Serum biomarkers predictive of
marijuana in the past 6 months (median: 2 joints/day [IQR: 1-4]), of whom 37% smoked daily; 40% smoked to relieve
fibrosis by proteomic fingerprinting in HIV-1/HCV co-infection
symptoms, 42% to increase appetite, and 46% for fun. There was no causal association between progression to liver fibrosis
and smoking occasionally (OR: 0.81 [95% CI: 0.49-1.34]), smoking ≤4 joints daily (OR: 0.47 [0.19-1.15]), or smoking >4 joints daily
(OR: 1.26 [0.61-2.63]), compared to individuals who did not smoke.
Conclusion:
Marijuana smoking does not have a causal effect on progression to liver disease in co-infected individuals. Self-medication,
causing time-dependent confounding, could have lead to the association observed in previous cross-sectional studies.
Authors:Brunet L, Moodie EE, Rollet K, Tyndall M, Potter M, Conway B, Walmsley S, Pick N, Cooper C, Cox J, Klein MB for the
Canadian Co-infection Cohort (CTN222)
Location: 21st Annual Canadian Conference on HIV/AIDS Research (CAHR 2012) Montreal
Background:
The literature on the effect of cannabis on liver diseases is conflicting. Cell cultures and animal model studies conclude that
cannabidiol could have a therapeutic effect on liver injuries. However, cross-sectional studies of chronic HCV patients suggest
that daily cannabis use is associated with fibrosis and steatosis. This study aims at estimating the causal effect of marijuana use
on liver fibrosis progression in the Canadian Co-infection Cohort study.
Methods:
HIV/HCV co-infected individuals were followed-up every six month. At each visit, they provided information on marijuana use
which was then categorized as (1) did not use, (2) used occasionally, (3) used daily, ≤4 joints/day, and (4) used daily, >4 joints/
day, based on the median. To account for time-dependent confounding, marginal structural pooled logistic regression models
were used to assess the effect of marijuana use on progression to significant fibrosis (APRI>=1.5). Baseline (age, sex, ethnicity,
low income, duration of HCV infection) and updated characteristics (CD4 cell count, HIV viral load, antiretroviral therapy,
alcohol use, illicit opioid use and other IDU) were included in the inverse probability of treatment weights calculation.
APRIL 2012
A total of 843 patients contributed 3,914 person-visits and 161 progressed to significant fibrosis. At baseline, 52% had smoked
Serum biomarkers predictive of
marijuana in the past 6 months (median: 2 joints/day [IQR: 1-4]), of whom 37% smoked daily; 40% smoked to relieve
fibrosis by proteomic fingerprinting in HIV-1/HCV co-infection
symptoms, 42% to increase appetite, and 46% for fun. There was no causal association between progression to liver fibrosis
and smoking occasionally (OR: 0.81 [95% CI: 0.49-1.34]), smoking ≤4 joints daily (OR: 0.47 [0.19-1.15]), or smoking >4 joints daily
(OR: 1.26 [0.61-2.63]), compared to individuals who did not smoke.
Conclusion:
Marijuana smoking does not have a causal effect on progression to liver disease in co-infected individuals. Self-medication,
causing time-dependent confounding, could have lead to the association observed in previous cross-sectional studies.
this topic is a bit like the 'occult HCV is not proven' arguments that regularly surface here. Thanks to tn's collection of relevant citations it's pretty clear there is a lot of evidence supporting existence of virus in serum-UND patients, including post SVR and there very little data showing any significant clinical effect -ie svr is cured.
Similarly, searches on PUBMED (try "+cannabinoid +fibrosis" ) will show that there is (a) a lot of direct evidence implicating the cellular cannabinoid receptors CB1 and CB2 with fibrosis regulation. (b) quite a number of studies linking daily cannabis use with increased steatosis/fibrosis.
At the molecular level, stimulation of CB1 promotes pathways that lead to fibrosis progression, dowregulation of CB1 and upregulation of CB2 have the opposite effect and promote fibrosis reduction. This effect is so clear that it has become the focus of a promising new area of anti-fibrotic drugs, eg
http://www.ncbi.nlm.nih.gov/pubmed/17975129
Putting aside the test-tubes, the effect of smoking a joint on the combined CB1 and CB2 effect is obviously hard to assess, however the effect is string enough that a number of studies have clearly linked daily use to increased fibrosis
http://www.ncbi.nlm.nih.gov/pubmed/18166478
and steatosis
http://www.ncbi.nlm.nih.gov/pubmed/18242211
On the other hand, consumption may help adherence to meds, sleep, diet, depression, etc. and contribute to overall QOL. So, just as with the occult-doesn't-mean-I'm-not-cured argument, a more realistic assessment of mj use may be that evidence supports a pro-fibrotic effect but that, with moderate use, benefits may outweigh damage.
Similarly, searches on PUBMED (try "+cannabinoid +fibrosis" ) will show that there is (a) a lot of direct evidence implicating the cellular cannabinoid receptors CB1 and CB2 with fibrosis regulation. (b) quite a number of studies linking daily cannabis use with increased steatosis/fibrosis.
At the molecular level, stimulation of CB1 promotes pathways that lead to fibrosis progression, dowregulation of CB1 and upregulation of CB2 have the opposite effect and promote fibrosis reduction. This effect is so clear that it has become the focus of a promising new area of anti-fibrotic drugs, eg
http://www.ncbi.nlm.nih.gov/pubmed/17975129
Putting aside the test-tubes, the effect of smoking a joint on the combined CB1 and CB2 effect is obviously hard to assess, however the effect is string enough that a number of studies have clearly linked daily use to increased fibrosis
http://www.ncbi.nlm.nih.gov/pubmed/18166478
and steatosis
http://www.ncbi.nlm.nih.gov/pubmed/18242211
On the other hand, consumption may help adherence to meds, sleep, diet, depression, etc. and contribute to overall QOL. So, just as with the occult-doesn't-mean-I'm-not-cured argument, a more realistic assessment of mj use may be that evidence supports a pro-fibrotic effect but that, with moderate use, benefits may outweigh damage.
Thanks your post helped me decide. I was debating with myself to switch to a anti-depresent pill instead of Marijuana With the help of your post i decided Marijuana is natural and i been smoking pretty much every day for a year give or take the 2-3 weeks i stop smoking at a time. Because i can take 3 weeks off of smoking with no feelings of want what so ever, I concluded its not addictive to me and a pill probably is seeing as i have never even taken anything more than aspirin ever..
I have a Medical Marijuana card which was issued two years ago. I smoked pot when I was in college and stopped for 40 years until two years ago when sleeping pills of all kinds did nothing for my Insomnia. My Hepatologist said to stop because he read in studies it showed it could, and I would like to underscore the word "could" cause acceleration of fibrosis.
My Gastro said the same thing, but there was no definitive proof. He signed the prescription to renew my card for this year. Remember the word "could". The study did not state if "definitely" causes acceleration of fibrosis (which I have).
I have cut back in case, to three nights a week instead of seven. I do two good hits with a vaporizer before I go to sleep and get up the next day after a good night's sleep and my mind is as clear as yours, or at least most of yours.
So, there is no published report from ANY major study from any medical institute that says the word "definitely", when referring to acceleration of fibrosis by nature's gift to mankind to help in many instances of suffering.
My take on all this is that it's up to you. I'm not advocating anything, but rather implying that there is not enough proof to solidify the rancor and the rattling of tongues to fully claim the connection between pot and acceleration of fibrosis...
Magnum.
My Gastro said the same thing, but there was no definitive proof. He signed the prescription to renew my card for this year. Remember the word "could". The study did not state if "definitely" causes acceleration of fibrosis (which I have).
I have cut back in case, to three nights a week instead of seven. I do two good hits with a vaporizer before I go to sleep and get up the next day after a good night's sleep and my mind is as clear as yours, or at least most of yours.
So, there is no published report from ANY major study from any medical institute that says the word "definitely", when referring to acceleration of fibrosis by nature's gift to mankind to help in many instances of suffering.
My take on all this is that it's up to you. I'm not advocating anything, but rather implying that there is not enough proof to solidify the rancor and the rattling of tongues to fully claim the connection between pot and acceleration of fibrosis...
Magnum.
I am kinda freeked by this post. Ill start from the top on why.
I am 23 years old and smoked marijuana for the first time when i was 23 because i started to become very depressed. I know for a fact use of any drug did not cause my problem because i never did any drugs of any kind ever. Before marijuana which remains my only one. It does help I limit though i never smoke more than one hit i don't want to get hi i want to feel better. (I smoke daily) but about maybe 1 gram a day if i am lucky lol.
What freeks me is by me smoking marijuana I smoke g-13 btw got a friend lol. I am going get Hepatitis C?
I am 23 years old and smoked marijuana for the first time when i was 23 because i started to become very depressed. I know for a fact use of any drug did not cause my problem because i never did any drugs of any kind ever. Before marijuana which remains my only one. It does help I limit though i never smoke more than one hit i don't want to get hi i want to feel better. (I smoke daily) but about maybe 1 gram a day if i am lucky lol.
What freeks me is by me smoking marijuana I smoke g-13 btw got a friend lol. I am going get Hepatitis C?
An x girlfrend of mine has fibro,dont know if its the same as above .anyway she smokes pot for relief of pain.I argue that shes in pain because she doesnt eat hardly at all except the odd bit of junk food and bulk coffee.If it wasnt for the coffees and sugars in it she probably fade away.She seams to think she will get fat if she eats .I smoke pot every day as a diabetic i believe it helps my eyes as they seam to be ok.lake of motavation though is the down side of it,strong pot lowers blood sugars a little as i have done many tests.Ah well better than alcohol
I am happy to see some agreement on the issue.
No question that drugs are not good for us. And we should try to do without them.
However, when symptoms from chronic illnesses rule the majority of your day (and night)... a little relief can be what holds you together and help you to continue the fight. I don't mean getting stoned either. Just comfortable.
Cheese
No question that drugs are not good for us. And we should try to do without them.
However, when symptoms from chronic illnesses rule the majority of your day (and night)... a little relief can be what holds you together and help you to continue the fight. I don't mean getting stoned either. Just comfortable.
Cheese
Ha ha well bush seems to of failed at smoked screaning himself and it looks like people r getting a bit sick of him trying to blow smoke up peoples a---s ( O;
PS if I was in cronic pain like my friend, end cancer point I certainly would not be worrying about the permanant sides of any thing either.
Aroha and peace Linda (o:
PS if I was in cronic pain like my friend, end cancer point I certainly would not be worrying about the permanant sides of any thing either.
Aroha and peace Linda (o:
at least we can all agree to disagree. :O)
p.s. no wonder your friend is messed up i could not smoke BUSH either i am an independent. : O )
p.s. no wonder your friend is messed up i could not smoke BUSH either i am an independent. : O )
I agree with what u say about Pot.I started smoking dope at 12 other drugs barbs speed heroin at 16 (OK I was tragic) by the way never smoked cigerettes or drank alcohol well didn't want to be an alcoholic or unhealthy?lol
Dope was the first drug I had to give up got paranoid and think think think.
The other drugs (except speed can be very scary if over done) were fun till friends started dieing around me from over doses etc.
I stopped using all drugs by the time I was twenty and brought my kids up in a complete drug free invironment I'm including gigies alcohol and even coffee in that.
Iv'e worked with a few street kids in the past and I have a friend that still does and dope seems to be creating more psychosis in kids than ever b4 probably because of hydro dope.
My conclusion- any drug that alters your perseption can f--- you up.
I know a few people that have smoked bush or non hydro dope for pain and its helped
Dope was the first drug I had to give up got paranoid and think think think.
The other drugs (except speed can be very scary if over done) were fun till friends started dieing around me from over doses etc.
I stopped using all drugs by the time I was twenty and brought my kids up in a complete drug free invironment I'm including gigies alcohol and even coffee in that.
Iv'e worked with a few street kids in the past and I have a friend that still does and dope seems to be creating more psychosis in kids than ever b4 probably because of hydro dope.
My conclusion- any drug that alters your perseption can f--- you up.
I know a few people that have smoked bush or non hydro dope for pain and its helped
To equate pot with other drugs I think is a huge mistake. When you look at the studies of Rastafarian's that have been heavy smokers their entire life, there is where you get the most startling evidence that pot is in a different league. Perfect health, IQ and memory normal or above normal. Rastafarian's' are a good population to study because pot is all they do, according to their religion they cannot drink or smoke cigs etc...
There has been some studies recently that were very interesting. One study found that there was no link between pot smoking and lung cancer, not only that but they found that people that smoke cigs AND pot were less likely to develop lung cancer than people that just smoked cigs.
Another study of people that use marijuana to alleviate pain associated with cancer showed that it might actually slow down tumor growth.
I have been addicted to almost every drug out there: heroin,coke,crack,meth,alcohol,valium,cigs,fat and sugar. I don't like getting stoned on weed. It makes me think too much, analyze my life, think about my relationship with my mother, think about what I AM doing wrong with my relationships. YUCK! I hate it, it's like going to a shrink.
Clearly this drug is different.
There has been some studies recently that were very interesting. One study found that there was no link between pot smoking and lung cancer, not only that but they found that people that smoke cigs AND pot were less likely to develop lung cancer than people that just smoked cigs.
Another study of people that use marijuana to alleviate pain associated with cancer showed that it might actually slow down tumor growth.
I have been addicted to almost every drug out there: heroin,coke,crack,meth,alcohol,valium,cigs,fat and sugar. I don't like getting stoned on weed. It makes me think too much, analyze my life, think about my relationship with my mother, think about what I AM doing wrong with my relationships. YUCK! I hate it, it's like going to a shrink.
Clearly this drug is different.
we can all justify the use of any type of drug illegal, legal, or otherwise, gimme a break!
there is positive uses for pot and there is positive uses for opiate based drugs
( morphine, synthetics, etc ). i believe it is how the drug is used by each individual. if you are abusing the drugs to the point that it dominates said persons, then said drug abuse could and most likely lead to an unhealthy and short term life span for said persons. to use a drug ( pot, opiate based drugs ) for tx or relief and for just that is in all likelyhood going to give said persons a better quality of life.
i do not think there is such a thing as recreational use. all drugs have a side affect to the bodys system, wether we see it right away or in the future we are going to see it.
and in some very rare situations some people will never realize said side affects in there lifetime.
for me i can abuse drugs and have and i am probably paying for it today, what it boils down for me is that i had a choice from 14 years old to my present age 51 and decided using for me had to end, as i believe it is a choice for all of us.
the bottom line drugs are just what they imply DRUGS.
i will finish by saying if i had a choice of suffering in pain and my only option would be morphine, pot opium,etc. to ease my suffering i would take it. believe me i am not into pain and suffering.
later you all. :O)
there is positive uses for pot and there is positive uses for opiate based drugs
( morphine, synthetics, etc ). i believe it is how the drug is used by each individual. if you are abusing the drugs to the point that it dominates said persons, then said drug abuse could and most likely lead to an unhealthy and short term life span for said persons. to use a drug ( pot, opiate based drugs ) for tx or relief and for just that is in all likelyhood going to give said persons a better quality of life.
i do not think there is such a thing as recreational use. all drugs have a side affect to the bodys system, wether we see it right away or in the future we are going to see it.
and in some very rare situations some people will never realize said side affects in there lifetime.
for me i can abuse drugs and have and i am probably paying for it today, what it boils down for me is that i had a choice from 14 years old to my present age 51 and decided using for me had to end, as i believe it is a choice for all of us.
the bottom line drugs are just what they imply DRUGS.
i will finish by saying if i had a choice of suffering in pain and my only option would be morphine, pot opium,etc. to ease my suffering i would take it. believe me i am not into pain and suffering.
later you all. :O)
I have major problems with the study too. The study included drinkers and iv drug users and I'm sorry you cannot completely accept what people from this group say about how much they drink or drug on a questionnaire. I should know, I lied or made myself look better on tons of medical questionnaires.
Another food for thought on the subject, how often has the medical community tried to find damning evidence on marijuana, only to have their little studies blown out of the water by larger ones? There is a long history here.
I bet if you did the same study except with cheeseburgers instead of weed you would find the same thing. Or Oreo cookies...HEY THATS IT...it's not the pot, its the cookies that you eat when you smoke the pot. HMMMM, I think I'm on to something here.
Another food for thought on the subject, how often has the medical community tried to find damning evidence on marijuana, only to have their little studies blown out of the water by larger ones? There is a long history here.
I bet if you did the same study except with cheeseburgers instead of weed you would find the same thing. Or Oreo cookies...HEY THATS IT...it's not the pot, its the cookies that you eat when you smoke the pot. HMMMM, I think I'm on to something here.
It is common public opinion that people with HCV have it due to their evil drug using lifestyle and that they get worse due to continued alcohol and drug use.
Yeah, even those thousands who got it from unclean operating instruments, tatoos, and the tainted blood scandel. Bunch of junkies huh?
They go on to get fibrosis, and worse.
What relief do their doctors give them for day after day, month after month, years of symptoms from any one or more of the well documented extrahepatic symptoms. Anti-depressants???
People with all sorts of chronic illnesses smoke pot for relief. It would be wrong to say that smoking pot got them to that stage of illness where they feel they need relief.
What I find interesting is that the study that claims that pot causes fibrosis, did not condcut the study over a few years, the article states that the data was obtained from a single session with each subject.
"A major limitation of the study is the method, since only one examination was performed, which limits the ability to establish a temporal relationship between cannabis use and fibrosis stage."
Coming to the conclusion that pot causes fibrosis without following the subjects for at least a few months, if not years is quite a leap and should be questioned.
Cheesegrater
Yeah, even those thousands who got it from unclean operating instruments, tatoos, and the tainted blood scandel. Bunch of junkies huh?
They go on to get fibrosis, and worse.
What relief do their doctors give them for day after day, month after month, years of symptoms from any one or more of the well documented extrahepatic symptoms. Anti-depressants???
People with all sorts of chronic illnesses smoke pot for relief. It would be wrong to say that smoking pot got them to that stage of illness where they feel they need relief.
What I find interesting is that the study that claims that pot causes fibrosis, did not condcut the study over a few years, the article states that the data was obtained from a single session with each subject.
"A major limitation of the study is the method, since only one examination was performed, which limits the ability to establish a temporal relationship between cannabis use and fibrosis stage."
Coming to the conclusion that pot causes fibrosis without following the subjects for at least a few months, if not years is quite a leap and should be questioned.
Cheesegrater
It is common public opinion that people with HCV have it due to their evil drug using lifestyle and that they get worse due to continued alcohol and drug use.
Yeah, even those thousands who got it from unclean operating instruments, tatoos, and the tainted blood scandel. Bunch of junkies huh?
They go on to get fibrosis, and worse.
What relief do their doctors give them for day after day, month after month, years of symptoms from any one or more of the well documented extrahepatic symptoms. Anti-depressants???
People with all sorts of chronic illnesses smoke pot for relief. It would be wrong to say that smoking pot got them to that stage of illness where they feel they need relief.
What I find interesting is that the study that claims that pot causes fibrosis, did not condcut the study over a few years, the article states that the data was obtained from a single session with each subject.
"A major limitation of the study is the method, since only one examination was performed, which limits the ability to establish a temporal relationship between cannabis use and fibrosis stage."
Coming to the conclusion that pot causes fibrosis without following the subjects for at least a few months, if not years is quite a leap and should be questioned.
Cheesegrater
Yeah, even those thousands who got it from unclean operating instruments, tatoos, and the tainted blood scandel. Bunch of junkies huh?
They go on to get fibrosis, and worse.
What relief do their doctors give them for day after day, month after month, years of symptoms from any one or more of the well documented extrahepatic symptoms. Anti-depressants???
People with all sorts of chronic illnesses smoke pot for relief. It would be wrong to say that smoking pot got them to that stage of illness where they feel they need relief.
What I find interesting is that the study that claims that pot causes fibrosis, did not condcut the study over a few years, the article states that the data was obtained from a single session with each subject.
"A major limitation of the study is the method, since only one examination was performed, which limits the ability to establish a temporal relationship between cannabis use and fibrosis stage."
Coming to the conclusion that pot causes fibrosis without following the subjects for at least a few months, if not years is quite a leap and should be questioned.
Cheesegrater
"Is it the health problems associated with advanced fibrosis that is causing people to seek relief from cannabis? Or is cannabis use actually CAUSING the fibrosis?"
Oh come on!! I know a lot of people with HCV that smoke Pot. It is not because their condition causes the Pot use. It is because they have smoked it since they were in their 20's and don't want to stop. They like it too much and are mentally addicted.
Most people like this are under the impression that Pot use doesn't affect their Livers? Wether this is true or not I don't know.
I had a DR once that told me Heroin doesn't affect your Liver. It may not but the Life style definitely does. Ingesting drugs that are cut with god knows what, not eating properly or not at all. But "Heroin isn't bad for your Liver"....yeah right.
Oh come on!! I know a lot of people with HCV that smoke Pot. It is not because their condition causes the Pot use. It is because they have smoked it since they were in their 20's and don't want to stop. They like it too much and are mentally addicted.
Most people like this are under the impression that Pot use doesn't affect their Livers? Wether this is true or not I don't know.
I had a DR once that told me Heroin doesn't affect your Liver. It may not but the Life style definitely does. Ingesting drugs that are cut with god knows what, not eating properly or not at all. But "Heroin isn't bad for your Liver"....yeah right.
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