Cannabis use as a factor of lower corpulence in hepatitis C-infected patients: results from the ANRS CO22 Hepather cohort
Authors: Barré Tangui , Carrat Fabrice , Ramier Clémence , Fontaine Hélène , Di Beo Vincent , Bureau Morgane , Dorival Céline , Larrey Dominique , Delarocque-Astagneau Elisabeth , Mathurin Philippe , Marcellin Fabienne , Petrov-Sanchez Ventzislava , Cagnot Carole , Carrieri Patrizia , Pol Stanislas , Protopopescu Camelia ,   the ANRS/AFEF Hepather study group, Alric Laurent , Pomes Chloe , Zoulim Fabien , Maynard Marianne , Bai Roxane , Hucault Lucie , Bailly François , Raffi François , Billaud Eric , Boutoille David , Lefebvre Maeva , André-Garnier Elisabeth , Cales Paul , Hubert Isabelle , Lannes Adrien , Lunel Françoise , Boursier Jérôme , Asselah Tarik , Boyer Nathalie , Giuily Nathalie , Castelnau Corinne , Scoazec Giovanna , Pol Stanislas , Fontaine Hélène , Rousseaud Emilie , Vallet-Pichard Anaïs , Sogni Philippe , de Ledinghen Victor , Foucher Juliette , Hiriart Jean-Baptiste , M’Bouyou Jancell , Irlès-Depé Marie , Bourlière Marc , Ahmed Si Nafa Si , Oules Valérie , Tran Albert , Anty Rodolphe , Gelsi Eve , Truchi Régine , Thabut Dominique , Hammeche Saloua , Moussali Joseph , Causse Xavier , De Dieuleveult Barbara , Ouarani Brahim , Labarrière Damien , Ganne Nathalie , Grando-Lemaire Véronique , Nahon Pierre , Brulé Séverine , Ulker Betul , Guyader Dominique , Jezequel Caroline , Brener Audrey , Laligant Anne , Rabot Aline , Renard Isabelle , Habersetzer François , Baumert Thomas F. , Doffoel Michel , Mutter Catherine , Simo-Noumbissie Pauline , Razi Esma , Bronowicki Jean-Pierre , Barraud Hélène , Bensenane Mouni , Nani Abdelbasset , Hassani-Nani Sarah , Bernard Marie-Albertine , Pageaux Georges-Philippe , Larrey Dominique , Meszaros Magda , Metivier Sophie , Bureau Christophe , Morales Thibault , Peron Jean Marie , Robic Marie Angèle , Decaens Thomas , Faure Marine , Froissart Bruno , Hilleret Marie-Noelle , Zarski Jean-Pierre , Riachi Ghassan , Goria Odile , Paris Fatima , Montialoux Hélène , Leroy Vincent , Amaddeo Giuliana , Varaut Anne , Simoes Mélanie , Amzal Rachida , Chazouillières Olivier , Andreani Tony , Angoulevant Bénédicte , Chevance Azeline , Serfaty Lawrence , Samuel Didier , Antonini Teresa , Coilly Audrey , Duclos-Vallée Jean-Charles , Tateo Mariagrazia , Abergel Armand , Reymond Maud , Brigitte Chanteranne , Benjamin Buchard , Muti Léon , Geist Claire , Conroy Guillaume , Riffault Raphaëlle , Rosa Isabelle , Barrault Camille , Costes Laurent , Hagège Hervé , Loustaud-Ratti Véronique , Carrier Paul , Debette-Gratien Maryline , Mathurin Philippe , Lassailly Guillaume , Lemaitre Elise , Canva Valérie , Dharancy Sébastien , Louvet Alexandre , Minello Anne , Latournerie Marianne , Bardou Marc , Mouillot Thomas , D’Alteroche Louis , Barbereau Didier , Nicolas Charlotte , Elkrief Laure , Jaillais Anaïs , Gournay Jérôme , Chevalier Caroline , Archambeaud Isabelle , Habes Sarah , Portal Isabelle , Gelu-Simeon Moana , Saillard Eric , Lafrance Marie-Josée , Catherine Lucie , Carrat Fabrice , Chau Frederic , Dorival Céline , Goderel Isabelle , Lusivika-Nzinga Clovis , Bellance Marc-Antoine , Bellet Jonathan , Monfalet Priscilla , Chane-Teng Jessica , Bijaoui Sephora , Pannetier Grégory , Téoulé François , Nicol Jérôme , Sebal Florian , Bekhti Rafika , Cagnot Carole , Boston Anaïs , Nailler Laura , Le Meut Guillaume , Diallo Alpha , Petrov-Sanchez Ventzislava , Bourlière Marc , Boursier Jérôme , Carrat Fabrice , Carrieri Patrizia , Delarocque-Astagneau Elisabeth , De Ledinghen Victor , Dorival Céline , Fontaine Hélène , Fourati Slim , Housset Chantal , Larrey Dominique , Nahon Pierre , Pageaux Georges-Philippe , Petrov-Sanchez Ventzislava , Pol Stanislas , Bruyand Mathias , Wittkop Linda , Zoulim Fabien , Zucman-Rossi Jessica , L’hennaff Marianne , Sizorn Michèle , Cagnot Carole 
Published: June 2022

Abstract
Background
Patients with chronic hepatitis C virus (HCV) infection are at greater risk of developing metabolic disorders. Obesity is a major risk factor for these disorders, and therefore, managing body weight is crucial. Cannabis use, which is common in these patients, has been associated with lower corpulence in various populations. However, this relationship has not yet been studied in persons with chronic HCV infection.

Methods
Using baseline data from the French ANRS CO22 Hepather cohort, we used binary logistic and multinomial logistic regression models to test for an inverse relationship between cannabis use (former/current) and (i) central obesity (i.e., large waist circumference) and (ii) overweight and obesity (i.e., elevated body mass index (BMI)) in patients from the cohort who had chronic HCV infection. We also tested for relationships between cannabis use and both waist circumference and BMI as continuous variables, using linear regression models.

Results
Among the 6348 participants in the study population, 55% had central obesity, 13.7% had obesity according to their BMI, and 12.4% were current cannabis users. After multivariable adjustment, current cannabis use was associated with lower risk of central obesity (adjusted odds ratio, aOR [95% confidence interval, CI]: 0.45 [0.37–0.55]), BMI-based obesity (adjusted relative risk ratio (aRRR) [95% CI]: 0.27 [0.19–0.39]), and overweight (aRRR [95% CI]: 0.47 [0.38–0.59]). This was also true for former use, but to a lesser extent. Former and current cannabis use were inversely associated with waist circumference and BMI.

Conclusions
We found that former and, to a greater extent, current cannabis use were consistently associated with smaller waist circumference, lower BMI, and lower risks of overweight, obesity, and central obesity in patients with chronic HCV infection. Longitudinal studies are needed to confirm these relationships and to assess the effect of cannabis use on corpulence and liver outcomes after HCV cure.

Trial registration
ClinicalTrials.gov identifier: NCT01953458.