Do statins reduce hepatitis C RNA titers during routine clinical use?  

作　　者：Kimberly A Forde Connie Law Rose O’Flynn David E Kaplan 

机构地区：[1]Philadelphia Veterans Administration Medical Center [2]Department of Medicine,Division of Gastroenterology,University of Pennsylvania [3]Department of Pharmacy,Philadelphia Veterans Administration Medical Center

出　　处：《World Journal of Gastroenterology》2009年第40期5020-5027,共8页世界胃肠病学杂志（英文版）

基　　金：Supported by The Veterans Health Administration Research Career Development Award (DEK)

摘　　要：AIM: To compare hepatitis C virus (HCV) titers in patients with chronic hepatitis C with and without exposure to 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins).METHODS: Medical records were reviewed for 6463 patients with documented HCV infection at a single center between March 2004 and September 2006. Patients with confi rmed viremia and meeting inclusion criteria were assigned to one of three groups: Group A (n = 50), dyslipidemic patients with statin usage during HCV RNA polymerase chain reaction (PCR) determination; Group B (n = 49), dyslipidemic patients with prior or future statin usage but not at the time of HCV RNA PCR determination; and Group C (n = 102), patients without statin usage during the study period. The primary analysis explored the effect of statin therapy on HCV viremia. Secondary analyses assessed class effect, dose response, and effect of other lipid-lowering therapies on HCV viral titers.RESULTS: Median HCV RNA titers did not signif icantly differ among the three groups (Group A: 4 550 000 IU/mL, Group B: 2 850 000 IU/mL, Group C: 3 055 000 IU/mL).For those subjects with longitudinal assessment of HCV viremia prior to and while on statins, there were no signif icant differences between pre- and post-HCV viral titers. Additionally, no differences in HCV titers were observed at any dose level of the most prescribed statin, simvastatin. However, hypertriglyceridemia independently correlated with HCV titers, and niacin exposure was associated with signif icantly lower viral titers (P < 0.05).CONCLUSION: There was no apparent effect of statins on HCV viral replication in this analysis. Further investigation is warranted to explore the possible antiviral properties of triglyceride-lowering agents and their potential role as adjuncts to standard HCV therapy.AIM： To compare hepatitis C virus （HCV） titers in patients with chronic hepatitis C with and without exposure to 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors （statins）.METHODS： Medical records were reviewed for 6463 patients with documented HCV infection at a single center between March 2004 and September 2006. Patients with confi rmed viremia and meeting inclusion criteria were assigned to one of three groups： Group A （n = 50）, dyslipidemic patients with statin usage during HCV RNA polymerase chain reaction （PCR） determination; Group B （n = 49）, dyslipidemic patients with prior or future statin usage but not at the time of HCV RNA PCR determination; and Group C （n = 102）, patients without statin usage during the study period. The primary analysis explored the effect of statin therapy on HCV viremia. Secondary analyses assessed class effect, dose response, and effect of other lipid-lowering therapies on HCV viral titers.RESULTS： Median HCV RNA titers did not signif icantly differ among the three groups （Group A： 4 550 000 IU/mL, Group B： 2 850 000 IU/mL, Group C： 3 055 000 IU/mL）.For those subjects with longitudinal assessment of HCV viremia prior to and while on statins, there were no signif icant differences between pre- and post-HCV viral titers. Additionally, no differences in HCV titers were observed at any dose level of the most prescribed statin, simvastatin. However, hypertriglyceridemia independently correlated with HCV titers, and niacin exposure was associated with signif icantly lower viral titers （P 〈 0.05）.CONCLUSION： There was no apparent effect of statins on HCV viral replication in this analysis. Further investigation is warranted to explore the possible antiviral properties of triglyceride-lowering agents and their potential role as adjuncts to standard HCV therapy.

关 键 词：Hepatitis C 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor STATINS Geranylgeranyl PRENYLATION 

分 类 号：R512.63[医药卫生—内科学]