Infection with hepatitis B virus (HBV) or hepatitis C virus (HCV) can lead to cirrhosis as well as liver cancer. A Hepatology study from Taiwan has found that statins may provide benefits to patients with HBV- or HCV-related cirrhosis.
When the liver fails to compensate for the functional overload resulting from disease, a situation called decompensation occurs. Decompensation significantly lowers the survival rate among patients with cirrhosis, and very few effective drugs are available. This latest study assessed information on 1350 cirrhotic patients identified from a representative group of Taiwan National Health Insurance beneficiaries from 2000 to 2013. Statin use was linked with a decreased the risk of decompensation in a dose-dependent manner.
Statins reduce the risk of decompensation in patients with liver cirrhosis due to hepatitis B virus (HBV) and hepatitis C virus (HCV) infections, according to a study published in Hepatology.1
Decompensated liver cirrhosis can lead to hepatic encephalopathy, ascites with spontaneous bacterial peritonitis and variceal bleeding, and is associated with increased mortality. Treating cirrhosis early on may help prevent or delay decompensation.
Statins have been shown to reduce portal hypertension related to liver cirrhosis in animal models. Limited clinical data suggest that statin use may lower rates of decompensation in patients with liver cirrhosis related to nonalcoholic steatohepatitis (NASH), HCV, or chronic HBV infection.1 However, these studies were performed in specific populations, such as male veterans with HCV-related cirrhosis, or had small sample sizes.2,3
Statins are known to decrease portal pressure in patients with cirrhosis and increase survival times of patients who have had bleeding episodes from varices. Statins have also been known to cause damage to the liver. Many physicians are reluctant to prescribe statins because of the potential risk to patients with liver disease.
The current study reviewed data from the Veteran Affairs Clinical Case Registry to determine if long-term use of statins is safe in patients with hepatitis C-related decompensated cirrhosis and if statins improve the survival time in patients with compensated cirrhosis. A total of 685 people who were statin users were matched with 2062 people who were nonusers for comparison.
Based on the current study, the risk of liver decompensation and death was more than 40% lower for the group of people that used statins. The authors did not recommend the use of statins for patients with liver disease or hepatitis C but importantly, they did not state that statins should be avoided.
This is good news! As the hepatitis C population ages, the use of statins will be more of an issue. It’s good to know that these studies are showing that statin use is safe. If people have compensated cirrhosis, it’s even more good news. Of course, one study doesn’t make it a fact—more studies are needed. A larger study that proves that statin use is safe, effective and proves to be protective as well would be a boom to people living with hepatitis C.