Research Section, Philadelphia Veterans Administration Medical Center, Research A402A, 3900 Woodland Avenue, Philadelphia, PA 19104, United States.
World J Gastroenterol. 2009 Oct 28;15(40):5020-7. doi: 10.3748/wjg.15.5020.
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).
Medical records were reviewed for 6463 patients with documented HCV infection at a single center between March 2004 and September 2006. Patients with confirmed 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.
Median HCV RNA titers did not significantly 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 significant 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 significantly lower viral titers (P < 0.05).
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.
比较慢性丙型肝炎病毒（HCV）感染患者中暴露于 3-羟基-3-甲基戊二酰辅酶 A 还原酶抑制剂（他汀类药物）前后的 HCV 滴度。
对 2004 年 3 月至 2006 年 9 月在一家单中心接受 HCV 感染确诊的 6463 例患者的病历进行了回顾性分析。符合入选标准且存在病毒血症的患者被分为三组：A 组（n = 50），HCV RNA 聚合酶链反应（PCR）检测时使用他汀类药物的血脂异常患者；B 组（n = 49），HCV RNA PCR 检测时未使用他汀类药物但在此前或之后使用过他汀类药物的血脂异常患者；C 组（n = 102），研究期间未使用他汀类药物的患者。主要分析探讨了他汀类药物治疗对 HCV 病毒血症的影响。次要分析评估了他汀类药物的种类、剂量反应以及其他降脂治疗对 HCV 病毒载量的影响。
三组患者的 HCV RNA 滴度中位数无显著差异（A 组：4 550 000 IU/mL，B 组：2 850 000 IU/mL，C 组：3 055 000 IU/mL）。对于那些在使用他汀类药物之前和之后进行 HCV 病毒血症纵向评估的患者，其 HCV 病毒载量在治疗前后无显著差异。此外，在最常使用的他汀类药物（辛伐他汀）的任何剂量水平下，HCV 滴度均无差异。然而，高甘油三酯血症与 HCV 滴度独立相关，烟酸暴露与 HCV 病毒载量显著降低相关（P < 0.05）。
在本分析中，他汀类药物对 HCV 病毒复制无明显影响。进一步研究需要探索降低甘油三酯药物的潜在抗病毒特性及其作为标准 HCV 治疗辅助药物的潜在作用。
