NORML: C 型肝炎
- Ingrid Wei
- Apr 13
- 3 min read
C型肝炎是一種肝臟病毒性疾病,估計影響約400萬名美國人。慢性C型肝炎通常伴隨疲勞、憂鬱、關節疼痛以及肝功能受損,包括肝硬化與肝癌等併發症。
科學家指出,內源性大麻素系統(endocannabinoid system)可能在調節慢性肝病的某些方面發揮作用。人口統計資料顯示,曾使用大麻的成年人罹患特定肝病(如非酒精性脂肪肝病,NAFLD)的風險低於未使用者。具體而言,麻薩諸塞大學於2017年的一項研究報告指出,頻繁使用大麻者罹患NAFLD的機率比未使用者低52%,而偶爾使用者的風險則降低15% [3]。史丹佛大學的研究亦指出,大麻使用與疑似NAFLD的風險呈劑量依賴性下降,研究者總結:「活躍的大麻使用對NAFLD具有保護作用,且此效應獨立於已知的代謝風險因子之外」[4]。
被診斷為C型肝炎的患者經常報告使用大麻以緩解疾病症狀及抗病毒治療引起的噁心感 [5-6]。加州大學舊金山分校(UCSF)研究人員進行的一項觀察性研究顯示,使用大麻的C型肝炎患者在治療期間的依從性顯著高於未使用者 [7]。
儘管早期的觀察性研究曾警告,C型肝炎患者若大量使用大麻可能對肝臟造成不利影響 [8-10],但近期研究指出,吸入大麻與C型肝炎患者的肝病進展無顯著關聯 [11],在某些情況下甚至可能具有保護作用 [12-14]。特別是,2019年一項涵蓋近600萬名受試者的九項研究綜述指出:「大麻使用並未增加HCV及HCV-HIV共感染患者罹患肝纖維化的盛行率或進展風險。相反地,我們觀察到大麻使用者的NAFLD盛行率有所下降」[15]。
另有縱向研究資料顯示,感染C型肝炎與HIV的共感染患者中,使用大麻者罹患胰島素阻抗的風險低於未使用者 [16]。更值得注意的是,根據2019年發表於《AIDS and Behavior》期刊的一項為期五年的縱向研究結果,具有大麻使用史的HIV/C型肝炎共感染患者,其死亡風險低於未使用者。研究作者指出:「定期/每日使用大麻、攝取較多咖啡以及不吸菸(煙草)與降低HCV相關死亡率具有獨立關聯。……應進一步探討大麻基礎療法的潛在益處」[17]。
參考文獻
[1] Zamora-Valdes et al. 2005. The endocannabinoid system in chronic liver disease (PDF). Annals of Hepatology 4: 248-254.
[2] Gabbey et al. 2005. Endocannabinoids and liver disease – review. Liver International 25: 921-926.
[3] Adejumo et al. 2017. Cannabis use is associated with reduced prevalence of non-alcoholic fatty liver disease: A cross-sectional study. PLoS One [open access journal].
[4] Kim et al. 2017. Inverse association of marijuana use with nonalcoholic fatty liver disease among adults in the United States. PLoS One [open access journal].
[5] Schnelle et al. 1999. Results of a standardized survey on the medical use of cannabis products in the German-speaking area. Forschende Komplementarmedizin (Germany) 3: 28-36.
[6] MedScape Today. 2004. “Hepatitis C – Current state of the art and future directions.” MedScape Today.
[7] Sylvestre et al. 2006. Cannabis use improves retention and virological outcomes in patients treated for hepatitis C. European Journal of Gastroenterology & Hepatology. 18: 1057-1063.
[8] Hezode et al. 2005. Daily Cannabis Smoking as a Risk Factor for Fibrosis Progression in Chronic Hepatitis C. Hepatology 42: 63-71.
[9] Ishida et al. 2008. Influence of cannabis use on severity of hepatitis C disease. Clinical Gastroenterology and Hepatology 6: 69-75.
[10] Parfieniuk and Flisiak. 2008. Role of cannabinoids in liver diseases. World Journal of Gastroenterology 14: 6109-6114.
[11] Brunet et al. 2013. Marijuana smoking does not accelerate progression of liver disease in HIV-hepatitis C coinfection: a longitudinal cohort analysis. Clinical Infectious Diseases 57: 663-670.
[12] Nordmann et al. 2017. Daily cannabis and reduced risk of steatosis in human immunodeficiency virus and hepatitis C virus co-infected patients. Journal of Viral Hepatitis [online ahead of print].
[13] Adejumo et al. 2018. Reduced incidence and better liver disease outcomes among chronic HCV infected patients who consume cannabis. Canadian Journal of Gastroenterology & Hepatology.[open access journal].
[14] Barre et al. 2021. Cannabis use and reduced risk of elevated fatty liver index in HIV-HCV co-infected patients: A longitudinal analysis. Expert Review of Anti-Infective Therapy [online ahead of print].
[15] Farooqui et al. 2019. Marijuana is not associated with progression of hepatic fibrosis in liver disease: A systemic review and meta-analysis. European Journal of Gastroenterology & Hepatology 31: 149-156.
[16] Patrizia-Carrie et al 2015. Cannabis use and reduced risk of insulin resistance in HIV-HCV infected patients: A longitudinal analysis. Clinical Infectious Diseases 61: 40-48.
[17] Santos et al. 2020. HCV-related mortality among HIV/HCV co-infected patients: The importance of behaviors in the HCV cure era. AIDS and Behavior 24: 1069-1084.
原文標題:《Hepatitis C》
原文作者:NORML
原始網站:https://norml.org
翻譯者:大麻101
翻譯日期:2025年4月
翻譯聲明:本文章由原文翻譯而來,原文發表於NORML。如需閱讀原文,請訪問 https://norml.org/marijuana/library/recent-medical-marijuana-research/hepatitis-c/
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