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Statins

Statins benefit patients with hepatitis B and C-related cirrhosis

Statins may benefit patients with cirrhosis of the liver caused by the Hepatitis B (HBV) or Hepatitis C (HCV) virus, according to the results of a Taiwan study published in Hepatology[1] (online, 20 March 2017).

Researchers found that cirrhotic patients who took statins showed a lower risk of decompensation — a failure of the liver to compensate for the overload generated by the disease — than non-statin users.

They conclude that statin therapy may be considered as an “adjuvant” therapy for preventing decompensation in patients with HBV and HCV-related cirrhosis of the liver but that more research was needed to confirm their findings.

The researchers based their results on an analysis of 1,350 patients with HBV or HCV-triggered cirrhosis between 2000 to 2013, who made use of Taiwan’s national health insurance scheme. They were divided into two equal groups of statin users and non-statin users.

They found that, for patients with cirrhosis, statin use of a cumulative defined daily dose (cDDD) of >28 decreased the risk of decompensation, mortality and hepatocellular carcinoma (p for trend: <0.0001,<0.0001 and 0.0009) compared to those who took no statins, or less than 28 cDDD.

There was a significantly lower risk of decompensation among statin users who had cirrhosis because of chronic HBV (adjusted hazard ratio [95% confidence interval], 0.39 [0.25—0.62]) or HCV (0.51 [0.29–0.93]).

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2017.20202672

Readers' comments (1)

  • There can always be another reason for an association.
    Statins are prescribed on the basis of LDL levels, not cirrhosis.
    People with higher LDL levels have a better prognosis in HCV infection and a lower risk of liver disease.
    Saturated fat, which elevates serum LDL to some extent, protects the liver from alcoholic liver disease and is probably protective in HCV infection because it down-regulates LDL receptors which are the viral entry point.
    PCSK9, associated with high LDL counts, also protects against HCV ingress, and statins do elevate PCSK9, despite also increasing LDL receptors.
    Thus it may be that the indications for statin use predict better outcomes in liver diseases, and that the effects of the statins do not completely abrogate this protection.
    For a discussion, see
    Henderson, George David, & Schofield, Grant. (2017). .Hypothesis - A modified very low carbohydrate ketogenic diet is an effective adjunct therapy for hepatitis C infection. http://doi.org/10.5281/zenodo.573025
    https://zenodo.org/record/573025#.WREq_fl97IU

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Supplementary images

  • Micrograph of cirrhosis of the liver

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