Department of Infectious Diseases, First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an 710061, Shaanxi, China.
Antiviral Res. 2013 Jun;98(3):373-9. doi: 10.1016/j.antiviral.2013.04.009. Epub 2013 Apr 16.
The treatment of interferon alfa (IFN-α) and ribavirin for chronic hepatitis C virus (HCV) infection achieves limited sustained virological response (SVR). We conducted a systematic review and meta-analysis to explore the efficacy of adding statins to IFN-α and ribavirin therapy for chronic hepatitis C. Studies with data pertinent to the effect of statins on chronic hepatitis C were reviewed, and randomized controlled trials (RCTs) evaluating the efficacy of the addition of statins to IFN-α and ribavirin were included in meta-analysis. The primary outcome measure was SVR. Secondary outcome measures were rapid virological response (RVR) and early virological response (EVR). The literature was systematically searched through October 2012. After screening of the 1724 non-duplicated entries, 54 potentially relevant studies were fully reviewed. Of those, 18 studies were relevant and 5 RCTs met the inclusion criteria for meta-analysis. In comparison with IFN-α and ribavirin therapy, the addition of statins significantly increased SVR (OR=2.02, 95% CI: 1.38-2.94), RVR (OR=3.51, 95% CI: 1.08-11.42) and EVR (OR=1.89, 95% CI: 1.20-2.98). The SVR increase remained significant for HCV genotype 1 (OR=2.11, 95% CI: 1.40-3.18). There were no significant increases in adverse events and withdrawals with the addition of statins. In conclusion, the addition of statins to IFN-α and ribavirin improves SVR, RVR, and EVR without additional adverse events and thus may be considered as adjuvant to IFN-α and ribavirin for chronic hepatitis C. Statins might also be used for HCV genotypes other than genotype 1, or in patients in whom the use of protease inhibitors is contraindicated or not indicated.
干扰素 α（IFN-α）和利巴韦林治疗慢性丙型肝炎病毒（HCV）感染的疗效有限，持续病毒学应答（SVR）率低。我们进行了系统评价和荟萃分析，以探索他汀类药物联合 IFN-α和利巴韦林治疗慢性丙型肝炎的疗效。我们对与他汀类药物对慢性丙型肝炎的影响相关的数据进行了研究，并纳入了评估他汀类药物联合 IFN-α和利巴韦林治疗效果的随机对照试验（RCT）进行荟萃分析。主要结局指标是 SVR。次要结局指标是快速病毒学应答（RVR）和早期病毒学应答（EVR）。通过系统搜索，文献检索截至 2012 年 10 月。在筛选出的 1724 个非重复条目后，有 54 项潜在相关研究进行了全面审查。其中，有 18 项研究相关，5 项 RCT 符合纳入荟萃分析的标准。与 IFN-α和利巴韦林治疗相比，他汀类药物联合治疗可显著提高 SVR（OR=2.02，95%CI：1.38-2.94）、RVR（OR=3.51，95%CI：1.08-11.42）和 EVR（OR=1.89，95%CI：1.20-2.98）。HCV 基因型 1 的 SVR 增加仍然显著（OR=2.11，95%CI：1.40-3.18）。他汀类药物联合治疗并未增加不良反应和停药率。总之，他汀类药物联合 IFN-α和利巴韦林可提高 SVR、RVR 和 EVR，且不会增加不良反应，因此可能被视为慢性丙型肝炎 IFN-α和利巴韦林的辅助治疗。他汀类药物也可用于除基因型 1 以外的 HCV 基因型，或在蛋白酶抑制剂禁用或不适用的患者中使用。
