Statins reduce risk of liver cancer, death in chronic viral hepatitis
Scientists examined cholesterol drugs' effect on complications in hepatitis B, C
Treatment with certain types of cholesterol-lowering drugs called statins may help reduce the risk of cirrhosis, or irreversible liver scarring, liver cancer, and death in people with chronic viral hepatitis, a meta-analysis of published studies suggests.
The study, “Statins exposure and adverse events in participants with chronic viral hepatitis: a meta-analysis based on cohort studies,” was published in npj Gut and Liver.
Some types of viral hepatitis, particularly hepatitis B and hepatitis C, can cause long-lasting chronic infections that can set the stage for cirrhosis and hepatocellular carcinoma (HCC), the most common type of liver cancer.
Statins lower levels of the cholesterol and are commonly prescribed to help reduce the risk of cardiovascular disease in people with high levels of the fatty molecule. They may also be used to help manage fatty liver disease, a condition marked by excessive fat buildup. Some research suggests that statins may reduce the risk of HCC in people with chronic viral hepatitis.
Scientists in China conducted a meta-analysis to examine the effects of statins on the risk of complications in people with chronic hepatitis B or C. In a meta-analysis, researchers pool data from multiple studies and analyze them collectively. Here, the research team reviewed studies published up to July 2024 on the effects of statins in adverse outcomes among chronic viral hepatitis patients. A total of 17 studies, covering more than 1.1 million people with chronic viral hepatitis, were included.
Statins effect on hepatitis B, C complications
Seven studies were from China, four from South Korea, three each from America and Europe. Ten included hepatitis C patients, nine included hepatitis B patients, and two had both patient populations. Eight different statins were used.
Pooled data showed that chronic viral hepatitis patients treated with statins had a significantly lower risk of cirrhosis and decompensated cirrhosis (by 46% each) and HCC (by 44%) than those who weren’t. Decompensated cirrhosis is when the liver can no longer perform its functions due to extensive scarring. The risk of death also was significantly lower, by about 37%, in patients given statins.
Statins’ effect on the risk of liver cancer and death was generally consistent in people with hepatitis B or C. However, their impact on mortality risk was a bit more dramatic in hepatitis C, reducing it by about 39%.
“Our meta-analysis underscores a significant benefit of statin exposure across the entire spectrum of chronic viral liver disease,” wrote the researchers, who noted rates of HCC and death tended to decrease as statin dosage increased, suggesting “higher doses of statins are correlated with greater benefits in reducing both the incidence of HCC and all-cause mortality.”
The effects on HCC risk seemed to vary based on the type of statin used. Statins can be broadly divided into two categories based on chemistry — hydrophilic statins, which dissolve in water, and lipophilic statins, which don’t dissolve in water. Hydrophilic statins include therapies like rosuvastatin (sold as Crestor) and pravastatin, while lipophilic statins include simvastatin (sold as Flolipid and Zocor), fluvastatin (sold as Lescol XL), pitavastatin (sold as Livalo), lovastatin (sold as Altoprev), and atorvastatin (sold as Atorvaliq and Lipitor).
The analysis suggests lipophilic statins significantly reduced the risk of HCC in chronic viral hepatitis.
“These findings suggest that lipophilic statins possess inherent anti–HCC properties, whereas hydrophilic statins do not demonstrate similar efficacy,” wrote the researchers, who said, taking the data collectively, the study “underscores the potential of statin therapy as a significant adjunct treatment in managing chronic viral hepatitis and its associated complications.”
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