Aim: This study aimed to analyze the association between any past-month cannabis use
and advanced liver fibrosis.
Background: Cannabinoid receptors play a role in acute and chronic liver injury, but human
studies addressing the impact of cannabis use on liver fibrosis have shown mixed results.
Objective: The objective of this study was to explore and estimate the association between pastmonth
cannabis use and advanced liver fibrosis (ALF) in a cohort of Russian HIV-positive individuals
with heavy alcohol use and a high prevalence of hepatitis C virus (HCV) coinfection.
Methods: Baseline data were analyzed from participants of the ZINC study, a trial that enrolled
HIV-positive Russian patients without prior antiretroviral therapy. Cannabis use during the prior
month was assessed at study entry. ALF was defined as FIB-4>3.25 and APRI>1.5. Transient elastography
was used to detect advanced liver fibrosis among participants with FIB-4 values in the intermediate
range (between 1.45 and 3.25).
Results: Participants (n=248) were mostly male (72.6%), young (median age of 33.9 years), infected
with HCV (87.9%), and did not have advanced immunosuppression (median CD4 count 465).
Cannabis use was uncommon (12.4%), and the prevalence of advanced liver disease was 21.7%.
The prevalence of ALF was similar among those who used cannabis compared to those who did
not (25.8% vs. 21.7%). We were unable to detect an association between cannabis use and ALF (adjusted
odds ratio: 1.28, 95% confidence interval: 0.53-3.12, p=0.59) in logistic regression models
adjusting for age, sex, heavy drinking, BMI, and CD4 cell count.
Conclusion: In this exploratory study among HIV-positive heavy drinking Russians, we did not detect
an association between recent cannabis use and ALF. Larger scale studies, including more participants
with cannabis use, are needed to examine this relationship further.