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Effectiveness and hepatotoxicity of statins in men seropositive for hepatitis C virus
Marisel Segarra-Newnham1, David Parra, Ellen M Martin-Cooper
1Pharmacy Department, Patient Support Service, Veterans Affairs Medical Center, West Palm Beach, Florida 33410-6400, USA. marisel.segarra-newnham@med.va.gov
Insights
Statins effectively lowered LDL cholesterol in men with Hepatitis C virus (HCV). This study found no significant increase in liver enzymes, suggesting statins are safe for HCV patients at risk for heart disease.
Area of Science:
- Cardiology
- Hepatology
- Pharmacology
Background:
- Hepatitis C virus (HCV) infection affects liver health.
- Cardiovascular disease is a significant concern in HCV patients.
- Statins are widely used for cholesterol management.
Purpose of the Study:
- To assess the efficacy of statins in reducing LDL cholesterol.
- To evaluate the hepatotoxicity of statins in HCV-seropositive individuals.
- To determine the safety profile of statin therapy in this population.
Main Methods:
- Retrospective review of a registry of 146 male HCV patients.
- Data collected on lipid and alanine aminotransferase (ALT) levels.
- Analysis of changes from baseline to long-term follow-up (mean 22 months).
Main Results:
- Statins achieved a mean 22% reduction in LDL cholesterol (p<0.01).
- No significant increases in ALT levels were observed.
- Only one patient discontinued statin therapy due to elevated ALT levels.
Conclusions:
- Statins are effective in lowering LDL cholesterol in men with HCV.
- Statin therapy did not lead to significant hepatotoxicity (elevated ALT levels).
- Consider statins for HCV patients with coronary heart disease risk if baseline transaminases are not elevated.
Study Objective:
To evaluate the effectiveness and hepatotoxicity of statins in patients who are seropositive for hepatitis C virus (HCV).
Design:
Retrospective review of a registry of patients with HCV.
Setting:
Veterans Affairs Medical Center.
Patients:
One hundred forty-six male patients who were seropositive for HCV and had received statin therapy between January 1, 1995, and September 9, 2003.
Measurements And Main Results:
Demographic and clinical data were collected for each patient; lipid and alanine aminotransferase (ALT) levels at baseline (within 6 mo of starting a statin), at 3 and 6 months after starting a statin, and at long-term follow-up (mean 22 mo) were also recorded. The primary efficacy end point was a significant decrease from baseline to long-term follow-up low-density lipoprotein cholesterol (LDL) level; the primary safety end point was a significant increase from baseline in ALT level. The mean change in LDL level was a reduction of 22% (p<0.01). No significant increases in ALT levels were observed; only one patient discontinued therapy due to ALT level elevations greater than 3 times the upper limit of normal.
Conclusion:
In men seropositive for HCV, statins were effective in reducing LDL levels and did not result in significant increases in ALT levels from baseline. Thus, statin therapy should be considered for patients with HCV who are at risk for coronary heart disease and do not have significantly elevated serum transaminase levels at baseline.
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