Is marijuana an effective treatment for the symptoms of hepatitis C?
General Reference (not clearly pro or con)
The US National Institute of Health stated on its website (accessed Sep. 29, 2006):
"Hepatitis C is an inflammation of the liver caused by infection with the hepatitis C virus (HCV).[...]
There are approximately 4 million people in the United States who are infected with hepatitis C (about 1 in 70 to 100 people). Other hepatitis virus infections include hepatitis A and hepatitis B. Each viral hepatitis infection is caused by a different virus.
Many people who are infected with the hepatitis C do not have symptoms. Hepatitis C is often detected during blood tests for a routine physical or other medical procedure. If the infection has been present for many years, the liver may be permanently scarred -- a condition called cirrhosis. In many cases, there may be no symptoms of the disease until cirrhosis has developed.
The following symptoms could occur with hepatitis C infection: Jaundice, Abdominal pain (right upper abdomen), Fatigue, Loss of appetite, Nausea, Vomiting, Low-grade fever, Pale or clay-colored stools, Dark urine, Generalized itching, Ascites, Bleeding varices (dilated veins in the esophagus)."
Is marijuana an effective treatment for the symptoms of hepatitis C?
Diana L. Sylvestre, MD, Assistant Clinical Professor in the Department of Medicine at the University of California, San Francisco, et al. stated in the Oct. 2006 article "Cannabis Use Improves Retention and Virological Outcomes in Patients Treated for Hepatitis C," published in the European Journal of Gastroenterology & Hepatology:
"Our results suggest that modest cannabis use may offer symptomatic and virological benefit to some patients undergoing HCV treatment by helping them maintain adherence to the challenging medication regimen."
Benedikt Fischer, PhD, Director of the Illicit Drugs, Public Health and Policy Unit at the Centre for Addictions Research at the University of Victoria, and Jens Reimer, MD, a Research Psychiatrist at the Center for Interdisciplinary Addiction Research at the University of Hamburg, et al., stated in their Oct. 2006 article "Treatment for Hepatitis C Virus and Cannabis Use in Illicit Drug User Patients: Implications and Questions," published in the European Journal of Gastroenterology & Hepatology:
"In fact, there is substantial evidence that cannabis use may help address key challenges faced by drug users in HCV treatment (e.g., nausea, depression), especially when such treatment occurs in the context of methadone maintenance treatment which may amplify these consequences.
While further research is required on the biological and clinical aspects of the benefits of cannabis use for HCV treatment, and the effectiveness of cannabis use for HCV treatment needs to be explored in larger study populations, we advocate that in the interim existing barriers to cannabis use are removed for drug users undergoing HCV treatment until the conclusive empirical basis for evidence-based guidance is available."
Rick Weiss, a science and medical reporter, discussed the study noted above (by Benedikt Fischer et al.) in his article "Marijuana Aids Therapy," published Sept. 13, 2006 in the Washington Post:
"Marijuana can improve the effectiveness of drug therapy for hepatitis C, a potentially deadly viral infection that affects more than 3 million Americans, a study has found. The work adds to a growing literature supporting the notion that in some circumstances pot can offer medical benefits.
Treatment for hepatitis C involves months of therapy with two powerful drugs, interferon and ribavirin, that have severe side effects, including extreme fatigue, nausea, muscle aches, loss of appetite and depression. Because of those side effects, many patients do not finish treatment and the virus ends up destroying their livers.
While it is possible that the marijuana had a specific, positive biomedical effect, it is more likely that it helped patients by reducing depression, improving appetite and offering psychological benefits that helped the patients tolerate the treatment's side effects, the team reports in the current issue of the European Journal of Gastroenterology & Hepatology."
Dean Edell, MD, a physician and radio show host, stated in a Nov. 30, 2000 article "I'm Getting Treatment For Hepatitis C. Will Marijuana Help Me Or Harm Me?" in response to a letter from an individual with Hepatitis C using marijuana, posted on HealthCentral.com:
"People...have used marijuana to fight nausea with no negative consequences and any anti-nausea drug that the doctor gives you will also be metabolized by the liver. I feel more secure with your liver trying to handle marijuana. Marinol, the FDA-approved pill form of marijuana has shown no toxicity to the liver.
I would estimate marijuana to be as safe as anything else. Interferon and ribarvirin is a pretty hefty combination that can be curative in a significant percentage of cases. It's basically all we have for hepatitis C. Interferon can make you pretty sick, but ribarvirin is fairly easy on you. They are both antiviral drugs."
David Bernstein, MD, Chief of Gastroenterology, Hepatology and Nutrition at the North Shore University Hospital and Long Island Jewish Health System, stated in his report "Hepatitis C - Current State of the Art and Future Directions," presented Oct. 31, 2004 at the 55th Annual Meeting of the American Association for the Study of Liver Diseases/Viral Liver Disease:
"Most hepatitis C experts agree that factors such as alcohol intake, coinfection with either hepatitis B or the human immunodeficiency virus [HIV], and age at infection may lead to the development of significant fibrosis [scarring of the liver].
Other factors remain elusive and not proven. Of particular interest is the effect of Cannabis sativa, or marijuana, on [HCV] disease progression. Many patients use marijuana for pleasure or to combat complaints of nausea associated with antiviral therapy. Marijuana is known to exert its effects via the CB1 and CB2 receptors. An upregulation of CB1 receptors has been found to be present in cirrhosis...
By both univariate [a process or mathematical expression with only one variable] and multivariate [a process or mathematical expression with multiple variables] analyses, daily marijuana smoking was found to be associated with the development of significant hepatic fibrosis. Thus, this study reports a strong association between daily marijuana use and fibrosis progression; the underlying mechanism needs to be further determined, although current data would suggest a role in the upregulation of the CB1 receptor.
These findings should encourage physicians to advise their patients with hepatitis C infection to avoid marijuana use. Further studies regarding this important and controversial topic need to be addressed."
Christophe Hezode, MD, of the Hôpital Henri Mondor, Creteil, France, et al. stated the following on Oct. 31, 2004 at the 55th Annual Meeting of the American Association for the Study of Liver Diseases, in describing his study of Hepatitis C patients who also used cannabis [marijuana]:
"This study shows a strong link between daily cannabis consumption and fibrosis [scarring of the liver] progression rate in patients with chronic hepatitis C...
Daily cannabis consumption should be avoided in patients with chronic hepatitis C. Patients with HCV infection who smoke cannabis to help with fatigue or appetite should really be aware that daily consumption could exacerbate their disease."