Coffee, Pot

Can Caffeine and Cannabis Be Helpful for HCV and HIV?
by Larry Buhl

Doctors agree that lifestyle choices, such as food and substance intake, play a part in the progression (or improvement) of chronic diseases such as hepatitis and HIV.

Caffeine, present in coffee, tea, chocolate, cola, and some over-the-counter medications, is metabolized through the liver, but despite the fears of some, is not directly harmful to the liver, according to doctors. In fact, a growing number of recent studies suggest that the consumption of caffeine may reduce the risk of liver cancer, and lower the risk of death from cirrhosis complications.

The January 2010 Journal of Hepatology documented a study from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) which determined that patients with chronic hepatitis C virus (HCV) who consumed more than 308mg of caffeine daily had milder liver fibrosis (scarring that occurs in the second stage of liver disease). The daily amount of caffeine intake found to be beneficial is equivalent to 2.25 cups of regular brewed coffee. Other sources of caffeine did not have the same therapeutic effect, and the author of the study, Dr. Apurva Modi, said it was unclear whether coffee itself or caffeine provided the benefits.

More recently, a study published in the June 2011 Journal of Hepatology looked for the association between caffeine intake and histological liver injury revealed by biopsies in people with untreated chronic HCV infection. From 2004 to 2006 Charlotte Costentin and colleagues in France evaluated 238 patients ranging from ages thirty-four to fifty-six and suffering with chronic hepatitis C (CHC). All participants were treatment-naive and had previously received or agreed to a liver biopsy. The study excluded those coinfected with hepatitis B or HIV.

Based on questionnaire answers, participants were classified into four groups reflecting their daily caffeine consumption over six months: Group one consumed less than 1.5 cups of coffee per day (or equivalent amount of caffeinated tea or soda); group two, between 1.5 and three cups, group three, between three and five cups, and group four, more than five cups a day. Serum ALT levels and fasting blood glucose were measured at the same time the liver biopsy was performed and the questionnaire administered.

The study compared participants’ caffeine consumption and its correlation with histological activity, a numerical scoring system to describe the rate of progression of cirrhosis, degree of fibrosis, and serum ALT levels. Researchers found that caffeine consumption greater than 408mg/day (three cups or more) was beneficial in reducing histological activity in patients with CHC. These findings, the authors said, support the theory that caffeine in sufficient quantities does have the ability to prevent further damage to the liver in people with chronic liver diseases.

However, researchers admitted that socioeconomic status and other factors significantly associated with coffee intake were not examined. Additionally, there was a low prevalence of alcohol use among study participants. For these reasons, researchers did not make any clinical recommendation regarding caffeine consumption.

And in the ever-widening “good for you/bad for you” debate of how substances affect diseases, studies about the beneficial effects of caffeine on HCV disease progression come with a big asterisk: In an article published in the October 2007 issue of Chemical Research in Toxicology, University of Washington researchers reported that caffeine and acetaminophen together are bad for the liver.

Many people with HIV/AIDS use medical marijuana to combat wasting and other symptoms. Marijuana use raises questions about whether and how it may affect HIV and its progression. Many immune cells express cannabinoid receptors, indicating that cannabis (the active substance in marijuana) may influence immune function, possibly negatively.

How, exactly, cannabis may affect immune function was the focus of a study described in the June 2011 issue of AIDS Research and Human Retroviruses. The findings may give confidence to those who use marijuana by showing that the drug might not speed up the progression of HIV and could even be beneficial in slowing progression.

Patricia Molina and colleagues from Louisiana State University Health Sciences Center examined the impact of ongoing administration of tetrahydrocannabinol (THC) in macaque monkeys exposed to simian immunodeficiency virus (SIV). Eight rhesus macaques received twice-daily injections of either THC or a placebo. After twenty-eight days, they were inoculated with a highly infectious dose of SIV. Results showed that during the initial six-month asymptomatic phase after infection, THC-treated monkeys lost CD4 cells more slowly than the placebo group, and had a significantly lower early mortality rate than placebo-treated animals. Monkeys in the THC group also experienced slightly less wasting and did not see an increased viral load or worsening immune dysfunction.

As with caffeine and HCV and many other studies in disease co-factors, the authors err on the side of caution, saying the results may be hopeful signs for people with HIV who use cannabis, but that the findings “warrant further study.”

Larry Buhl is a freelance journalist and screenwriter living in Los Angeles.

July 2011