Clark Eva H, Ahmed Sarah T, Chang Elaine, Chiao Elizabeth Y, White Donna L
Section of Infectious Diseases, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
Center for Innovation, Quality, Effectiveness and Safety (IQuESt), Michael E. DeBakey VA Medical Center, Houston, TX, USA.
Infect Agent Cancer. 2022 Sep 4;17(1):47. doi: 10.1186/s13027-022-00460-0.
Oncogenic viruses, including hepatitis B virus (HBV), hepatitis C virus (HCV), human papillomavirus (HPV), Epstein Barr virus (EBV), and Kaposi Sarcoma Herpes virus (KSHV) contribute to a significant proportion of the world's cancers. Given the sizeable burden of virus mediated cancers, development of strategies to prevent and/or treat these cancers is critical. While large population studies suggest that treatment with hydroxymethylglutaryl-CoA reductase inhibitors, commonly known as statins, may reduce the risk of many cancer types including HBV/HCV related hepatocellular carcinoma, few studies have specifically evaluated the impact of statin use in populations at risk for other types of virus mediated cancers.
Studies of populations with HBV and HCV suggest a protective, dose-dependent effect of statins on hepatocellular carcinoma risk and support the theory that statins may offer clinical benefit if used as chemoprophylactic agents to reduce liver cancer incidence. However, no population level data exists describing the impact of statins on populations with other oncogenic viral infections, such as HPV, EBV, and KSHV.
Further study of statin use in diverse, global populations with or at high risk for oncogenic viral infections is essential to determine the impact of statin therapy on virus mediated cancer risk.
致癌病毒,包括乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)、人乳头瘤病毒(HPV)、爱泼斯坦-巴尔病毒(EBV)和卡波西肉瘤疱疹病毒(KSHV),在全球相当一部分癌症中起作用。鉴于病毒介导的癌症负担巨大,制定预防和/或治疗这些癌症的策略至关重要。虽然大规模人群研究表明,使用羟甲基戊二酰辅酶A还原酶抑制剂(通常称为他汀类药物)治疗可能会降低包括HBV/HCV相关肝细胞癌在内的多种癌症类型的风险,但很少有研究专门评估他汀类药物对其他类型病毒介导癌症高危人群的影响。
对HBV和HCV人群的研究表明,他汀类药物对肝细胞癌风险具有保护作用,且呈剂量依赖性,并支持这样一种理论,即如果将他汀类药物用作化学预防剂以降低肝癌发病率,可能会带来临床益处。然而,目前尚无人群水平的数据描述他汀类药物对其他致癌病毒感染人群(如HPV、EBV和KSHV)的影响。
进一步研究他汀类药物在感染致癌病毒或处于致癌病毒高风险的全球不同人群中的使用情况,对于确定他汀类药物治疗对病毒介导的癌症风险的影响至关重要。