Aim: This study aimed to analyze the association between any past-month cannabis use and advanced liver fibrosis.

Background: Cannabinoid receptors play a role in acute and chronic liver injury, but human studies addressing the impact of cannabis use on liver fibrosis have shown mixed results.

Objective: The objective of this study was to explore and estimate the association between pastmonth cannabis use and advanced liver fibrosis (ALF) in a cohort of Russian HIV-positive individuals with heavy alcohol use and a high prevalence of hepatitis C virus (HCV) coinfection.

Methods: Baseline data were analyzed from participants of the ZINC study, a trial that enrolled HIV-positive Russian patients without prior antiretroviral therapy. Cannabis use during the prior month was assessed at study entry. ALF was defined as FIB-4>3.25 and APRI>1.5. Transient elastography was used to detect advanced liver fibrosis among participants with FIB-4 values in the intermediate range (between 1.45 and 3.25).

Results: Participants (n=248) were mostly male (72.6%), young (median age of 33.9 years), infected with HCV (87.9%), and did not have advanced immunosuppression (median CD4 count 465). Cannabis use was uncommon (12.4%), and the prevalence of advanced liver disease was 21.7%. The prevalence of ALF was similar among those who used cannabis compared to those who did not (25.8% vs. 21.7%). We were unable to detect an association between cannabis use and ALF (adjusted odds ratio: 1.28, 95% confidence interval: 0.53-3.12, p=0.59) in logistic regression models adjusting for age, sex, heavy drinking, BMI, and CD4 cell count.

Conclusion: In this exploratory study among HIV-positive heavy drinking Russians, we did not detect an association between recent cannabis use and ALF. Larger scale studies, including more participants with cannabis use, are needed to examine this relationship further.

目的：本研究旨在分析过去一个月的任何大麻使用与晚期肝纤维化之间的关联。

背景：大麻素受体在急性和慢性肝损伤中发挥作用，但针对大麻使用对肝纤维化影响的人体研究显示出喜忧参半的结果。

目的：本研究的目的是探索和估计过去一个月大麻使用与晚期肝纤维化 (ALF) 之间的关联，在一组俄罗斯 HIV 阳性、大量饮酒和丙型肝炎病毒 (HCV) 合并感染率高的人群中.

方法：对 ZINC 研究参与者的基线数据进行分析，该试验招募了未经抗逆转录病毒治疗的 HIV 阳性俄罗斯患者。在研究开始时评估前一个月的大麻使用情况。ALF 定义为 FIB-4>3.25 和 APRI>1.5。瞬时弹性成像用于检测 FIB-4 值在中间范围（1.45 和 3.25 之间）的参与者的晚期肝纤维化。

结果：参与者（n=248）大多为男性（72.6%）、年轻（中位年龄 33.9 岁）、感染 HCV（87.9%），并且没有晚期免疫抑制（中位 CD4 计数 465）。大麻的使用并不常见（12.4%），晚期肝病的患病率为 21.7%。与不使用大麻的人相比，使用大麻的人的 ALF 患病率相似（25.8% 对 21.7%）。在调整年龄、性别、酗酒、BMI 和 CD4 细胞的逻辑回归模型中，我们无法检测到大麻使用与 ALF 之间的关联（调整优势比：1.28，95% 置信区间：0.53-3.12，p=0.59）数数。

结论：在这项针对 HIV 阳性大量饮酒的俄罗斯人的探索性研究中，我们没有发现近期使用大麻与 ALF 之间的关联。需要更大规模的研究，包括更多使用大麻的参与者，以进一步检验这种关系。