Abstract
ObjectivesTo evaluate the risk of complication in hospitalized chronic hepatitis C (CHC), patients with cannabis use disorder (CUD).MethodsWe conducted a retrospective study using the nationwide inpatient sample (NIS), and included 31,623 patients (age 15-54) with a primary international classification of diseases, ninth revision (ICD-9) diagnosis for CHC and grouped by co-diagnosis of CUD (1101, 3.5%). Logistic regression model adjusted for confounders was used to evaluate the odds ratio (OR) of CUD and complications during CHC hospitalization.ResultsComorbid CUD was prevalent in males (73.2%), Caucasians (59.9%), and from low-income families (65.7%). The most prevalent complications in patients with CUD were ascites (44.9%), alcoholic cirrhosis (42.8%) and non-alcoholic cirrhosis (41.1%). The odds of association for hepatic encephalopathy was 2.2 times higher (95% CI 1.477-3.350) in 2.8% CHC inpatients with CUD compared to 1.2% non-CUD inpatients. Hepatic encephalopathy had higher odds of association with a male by 1.4 times (95% CI 1.094-1.760), and African American by 1.7 times (95% CI 1.293-2.259).ConclusionCUD is significantly associated with 122% increased likelihood for hepatic encephalopathy that may worsen overall hospitalization outcomes in CHC patients. Hence, we need to consider the complex relationship between CUD and CHC and manage them optimally to improve the health-related quality of life.
Highlights
Cirrhosis is the chronic liver disease in critical stage caused by the hepatitis C virus (HCV) infection
The odds of association for hepatic encephalopathy was 2.2 times higher in 2.8% chronic hepatitis C (CHC) inpatients with cannabis use disorder (CUD) compared to 1.2% non-CUD inpatients
CUD is significantly associated with 122% increased likelihood for hepatic encephalopathy that may worsen overall hospitalization outcomes in CHC patients
Summary
Cirrhosis is the chronic liver disease in critical stage caused by the hepatitis C virus (HCV) infection. Risk factors for fibrosis progression in cirrhosis include male gender, higher age at the time of HCV infection, duration of infection, alcohol consumption, and co-infection with human immunodeficiency virus (HIV) [1]. Cannabis is widely used for medicinal and recreational purposes. It consists of about 60 cannabinoid compounds, including delta-9-tetrahydrocannabinol (delta-9-THC), which is the most active component of cannabis [2]. In the US, the prevalence of cannabis use among adults is estimated to be four percent. It increases in specific population subgroups, including 18 to 29-years old individuals [3]. Many studies suggest that cannabinoids have an important, yet undefined, role in hepatic fibrosis as cannabinoid CB1 receptor inactivation promotes the development of fibrosis while cannabinoid CB2 receptor activation exerts an inhibitory effect [4,5]
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