Hepatitis is a vital disease of the liver that afflicts an estimated 4 million Americans. Chronic Hepatitis C is typically associated with fatigue, depression, joint pain and liver impairment including cirrhosis and liver cancer.
Patients diagnosed with Hepatitis C frequently report using cannabis to treat both the symptoms of the disease as well as the nausea associated with anti-viral therapy. Most recently an observational study by investigators at the University of California San Francisco(UCSF) found that the hepatitis C patients who use d cannabis were significantly more likely to adhere to their treatment regiment than patients who didn’t use it. Nevertheless, no clinical trials assessing the use of cannabinoids for the indication are available in the scientific literature.
Preclinical data indicates that the endocannabinoid system may moderate aspects of chronic liver disease and that the cannabinoids may reduce the inflammation in the experimental models of hepatitis. However, a recent review of 270 untreated patients of hepatitis C found that daily cannabis smoking was associated with fibrosis progression.
Preclinical data demonstrates that the development of liver fibrosis may be regulated with cannabinoid receptors, with some studies indicating that upregulation of CBI receptors in certain liver cells may be positively associated with fibrosis. By contrast, mice lacking kCBI receptors have been shown to develop experimental liver fibrosis at a decreased rate compared to normal mice. Administration of the CBI cannabis receptors antagonist SR141716a (rimonabant) also inhibits fibrosis progression in animal models, as does activation of the CB2 receptor.
The role of the endocannabinoid system in liver disease, though not yet well understood, arguably warrants further investigation. However, experts at this time hold divergent opinions on the therapeutic use of cannabinoids for the treatment of hepatitis C. Writing in the October issue of the European journal of Gastroenterology, investigators from Canada and Germany concluded that cannabis, “potential benefits of a higher likelihood of treatment success [for hepatitis C patients] appear to outweigh [its] risks.” By contrast, other experts advise that hepatitis C patients abstain from the regular use of cannabis until further studies are performed.