Globally speaking, Hepatitis C infection, caused by the Hepatitis C virus, represents the most common cause of liver disease. Although the virus does not often cause immediate problems, it resides in the liver many years after infection and over that length of time gradually causes liver failure. Fortunately for modern society, Direct Acting Antivirals (DAA’s) have been shown to limit the progression of the disease and stabilize HCV infected individuals. However, these medications are not perfectly effective, leaving a small percentage of patients with no solution. Additionally, in the real world of medical treatment, economic factors come into play; what happens when an individual is from an economic class without financial ability to obtain medication?
Although these seem like small problems, readers may note that HCV is more likely to affect lower-income patients in the first place. Hepatitis C generally spreads in blood-to-blood contact, meaning the most common route of infection is through needle sharing or accidental transfusions. Given that this type of drug use is more common in areas of economic downturn, and given needle-sharing is most common to homeless populations, many individuals are left untreated with incrementally worsening liver disease.
Over the past few decades, researchers have attempted to understand the impact of other lifestyle factors on HCV, including cannabis use. As readers know, cannabis has been shown to reduce inflammation all over the body, including in the liver. Readers may make an educated guess, therefore, that cannabis use might reduce the impact of HCV on the human body. Ironically, however, early studies indicated that this was not the case. Because cannabis can also reduce the immune system response, scientists reasoned that the downturned immune response outweighed the anti-inflammatory properties produced by cannabis. However, as researchers are also aware, the scientific process is never as cut and dry as it seems. A result seen in a sample size of 20 patients may not be duplicated at all in a sample size of 1000. This is due to sample-bias, which occurs when small numbers of patients do not represent a statistical distribution of the general population. Often small selections can be used to bias data in the direction researchers hope to prove, which is why anti-cannabis lobbies are almost always able to generate reports stating that cannabis is unhealthy and dangerous, even at a time when CBD is being embraced by the medical community.
To get to the bottom of cannabis’ real relationship with HCV-infected patients, researchers in Massachusetts finally examined a nationally-representative sample of over 900,000 subjects infected with HCV (close to a million patients!). Researchers attempted to eliminate differences in demographics of study participants to form a conclusive answer: should individuals with HCV-induced liver disease be using cannabis?
Researchers obtained public records of patients from 2007 to 2014 from the Healthcare Cost and Utilization Project. Starting with a bank of more than 917,000 HCV-infected patients, researchers reduced the sample to patients with only the HCV form of liver disease, leaving 224,000 patients. Researchers did this to eliminate effects of other liver diseases. For instance, if cannabis helps HCV-caused liver disease but worsens other forms, this could cloud statistical data. Next, researchers reduced the population bank to patients not exhibiting health or health behaviors that worsen liver disease, such as using tobacco or having diabetes. Finally, researchers separated the group into those using cannabis and those not using cannabis, yielding a sample of 4,728 cannabis users and an equal number of cannabis non-users. This represents a strong, robust sample size, whose results should be indicative of the larger population of patients with only HCV liver disease.
The results from the study are clear: “cannabis users had lower frequencies for liver cirrhosis and its complications, lower frequencies of higher Baveno4 scores, and unfavorable discharges.” Baveno4 scores are scores from a test that indicate cirrhotic decompensation or the general progression of liver disease. Cannabis users had a cirrhosis prevalence rate of 40.18 per 1,000 hospitalizatoins vs. 49.72 per 1,000 hospitalizations. In other words, cannabis users showed a 20% decrease in liver cirrhosis! Furthermore, “compared to nondependent cannabis users, dependent users had a 38% decreased prevalence of liver cirrhosis.” In other words, chronic cannabis users had a much better outcome than patients who only occasionally smoked, indicating that the level of protection has some relationship with the quantity of cannabis consumed (at least up to a point).
This data indicates in a very large sample size that cannabis use is likely good for liver disease caused by HCV. In fact, these benefits outweigh many pharmaceutical drugs currently on the market, meaning that as is, un-altered, cannabis may already out-perform much more expensive, laboratory-made options. It goes without saying that individuals with HCV should take diagnosis with the upmost seriousness and follow their physicians’ medical recommendations without deviation. Patients should not ever attempt to replace trained medical help with home cannabis use, especially given the variability in cannabis types. However, specifically in regard to the question, “is smoking cannabis good for patients with HCV?” The answer appears to be a resounding “yes”. Patients with HCV seem to benefit from use, likely due to the anti-inflammatory properties stemming from star cannabinoids like CBD.
Adeyinka Charles Adejumo, Oluwole Muyiwa Adegbala, et al. Reduced Incidence and Better Liver Disease Outcomes among Chronic HCV Infected Patients Who Consume Cannabis. Cannadian Journal of Gastroenterology and Hepatology (2018). DOI: 10.1155/2018/9430953.