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.”

Oct. 31, 2004