Cannabis use did not reduce hepatitis C cure rates in patients on opioid substitution therapy
In a real-world registry of nearly 8,000 hepatitis C patients, cannabis use had no significant effect on cure rates (SVR) in either standard patients or those on opioid substitution therapy.
Quick Facts
What This Study Found
Cannabis use did not significantly influence SVR rates in either intention-to-treat or per-protocol analysis, regardless of opioid substitution therapy status. High alcohol consumption slightly reduced ITT cure rates (due to more lost-to-follow-up), but per-protocol rates were similar. OST patients had higher LTFU rates but similar per-protocol cure rates.
Key Numbers
739 OST patients, 7,008 non-OST. Non-OST/no drug use SVR: 91-92% (ITT). OST SVR: 83-86% (ITT). Difference mainly due to LTFU (11-12% vs 2-3%). Cannabis use: no significant effect on SVR in any analysis.
How They Did This
Analysis of the German Hepatitis C Registry (DHC-R), a national multicenter prospective real-world registry. 739 OST patients and 7,008 non-OST patients treated with direct-acting antivirals.
Why This Research Matters
Concerns about cannabis and alcohol use in hepatitis C patients on opioid substitution have led some clinicians to defer or deny treatment. This study shows these concerns are unfounded for cure rates.
The Bigger Picture
This large registry study removes a barrier to treating hepatitis C in substance-using populations. If cannabis and alcohol do not reduce cure rates, there is no pharmacological reason to withhold treatment from these patients.
What This Study Doesn't Tell Us
Self-reported substance use may be underestimated. Cannabis type and quantity not specified. LTFU after end of treatment could mask some treatment failures. German healthcare context may not generalize to all settings.
Questions This Raises
- ?Should substance use screening be used to guide HCV treatment decisions?
- ?Does cannabis affect treatment adherence even if it does not affect cure rates?
- ?Would similar results be seen with other drug classes?
Trust & Context
- Key Stat:
- Cannabis: no effect on cure rates
- Evidence Grade:
- Rated strong because this is a large national registry with nearly 8,000 patients and prospective data collection.
- Study Age:
- Published in 2019.
- Original Title:
- Alcohol and Cannabis Consumption Does Not Diminish Cure Rates in a Real-World Cohort of Chronic Hepatitis C Virus Infected Patients on Opioid Substitution Therapy-Data From the German Hepatitis C-Registry (DHC-R).
- Published In:
- Substance abuse : research and treatment, 13, 1178221819835847 (2019)
- Authors:
- Christensen, Stefan, Buggisch, Peter, Mauss, Stefan, Böker, Klaus Hw, Müller, Tobias, Klinker, Hartwig, Zimmermann, Tim, Serfert, Yvonne, Weber, Bernd, Reimer, Jens, Wedemeyer, Heiner
- Database ID:
- RTHC-01985
Evidence Hierarchy
Enrolls participants and follows them forward in time.
What do these levels mean? →Frequently Asked Questions
Does cannabis use affect hepatitis C treatment?
No. In this large German registry, cannabis use had no significant effect on cure rates for hepatitis C, whether patients were on opioid substitution therapy or not.
Should substance users be treated for hepatitis C?
This study supports treating substance-using patients. Cure rates were similar when controlling for treatment completion, and neither cannabis nor moderate alcohol use reduced effectiveness.
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Cite This Study
https://rethinkthc.com/research/RTHC-01985APA
Christensen, Stefan; Buggisch, Peter; Mauss, Stefan; Böker, Klaus Hw; Müller, Tobias; Klinker, Hartwig; Zimmermann, Tim; Serfert, Yvonne; Weber, Bernd; Reimer, Jens; Wedemeyer, Heiner. (2019). Alcohol and Cannabis Consumption Does Not Diminish Cure Rates in a Real-World Cohort of Chronic Hepatitis C Virus Infected Patients on Opioid Substitution Therapy-Data From the German Hepatitis C-Registry (DHC-R).. Substance abuse : research and treatment, 13, 1178221819835847. https://doi.org/10.1177/1178221819835847
MLA
Christensen, Stefan, et al. "Alcohol and Cannabis Consumption Does Not Diminish Cure Rates in a Real-World Cohort of Chronic Hepatitis C Virus Infected Patients on Opioid Substitution Therapy-Data From the German Hepatitis C-Registry (DHC-R).." Substance abuse : research and treatment, 2019. https://doi.org/10.1177/1178221819835847
RethinkTHC
RethinkTHC Research Database. "Alcohol and Cannabis Consumption Does Not Diminish Cure Rate..." RTHC-01985. Retrieved from https://rethinkthc.com/research/christensen-2019-alcohol-and-cannabis-consumption
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.