A
laboratory study published this summer showed that HMG-CoA reductase inhibitors
-- better known as statins -- were active against hepatitis
C virus (HCV), especially when combined with interferon. However, there is
some concern that statins, which are prescribed to treat elevated cholesterol,
can cause liver
toxicity.
They identified 174 patients seen between 2000 and 2004 who
had chronic hepatitis C and were prescribed a statin. They also assembled 2 control
cohorts: 129 patients with chronic hepatitis C who were not on statins, and 116
patients without HCV who were taking statins. Individuals with HBV or HIV coinfection
were excluded. Baseline liver function tests -- including levels of the liver
enzymes ALT and AST -- were recorded prior to statin initiation and at 3-9 month
intervals over 2 years.
Results
Most patients
were men (97%) and Caucasian (74%), with a mean age of 59.6 years and a mean body
mass index (BMI) of 29.2.
No patients in any group experienced symptomatic hepatotoxicity.
Statins discontinued due to increased liver enzymes was not more likely in patients
with hepatitis C than in HCV negative individuals (8 total discontinuations; 4%
vs 0.9%; P = non-significant).
However, statins were discontinued for any reason more frequently in the group
with hepatitis C (17.8% vs 8.6%; P < 0.05).
Although mean baseline ALT and AST levels were significantly different between
the 3 groups, the mean and maximum changes in liver enzyme levels from baseline
were not significantly different, as shown in the table below.
Group
Mean
AST (U/L) Normal < 34
Mean
ALT (U/L) Normal < 65
Baseline
Max change
from baseline
Mean change
from baseline
Baseline
Max change
from baseline
Mean change
from baseline
HCV+ on statins
33.7
6.8
2.5
59.7
8.6
3.3
HCV+ no statins
52.2
6.9
.9
85.3
7.7
3.0
HCV- on statins
23.9
1.1
.4
46.2
-.8
-.8
Conclusion
"We
found that patients with chronic HCV who were taking statins were not more likely
to develop significant elevations in aminotransferases than control patients,"
the researchers concluded. "The results of our study indicate that statins
can be safely used in the majority of patients in whom hyperlipidemia and chronic
HCV coexist."
11/14/06
Reference V
Krishna, M Mann, R Yen, and others. Effect of Statin Use in Patients with Chronic
HCV. 57th AASLD. Boston, MA. October 27-31, 2006. Abstract 894.
Most patients
were men (97%) and Caucasian (74%), with a mean age of 59.6 years and a mean body
mass index (BMI) of 29.2. 
