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Statin Therapy and Serum Transaminases Among a Cohort of HCV-Infected Veterans

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Abstract

Background

We sought to determine the effect of statin therapy on serum AST and ALT levels in a cohort of HCV-infected veterans with well-characterized liver disease.

Study

We examined liver biopsy records of consecutive HCV-infected patients and identified 20 patients who were prescribed statins. We matched them on age, stage of fibrosis, and time between HCV diagnosis and statin start dates with up to four HCV-infected patients who did not use statins. ALT and AST values from up to four time points within 1 year of follow-up were abstracted from the medical record. We compared median ALT and AST levels using Wilcoxon–Mann–Whitney tests and assessed changes in ALT and AST over time between the statin and non-statin groups using a non-parametric repeated measures ANOVA model, adjusting for the matching factors, receipt of HCV treatment, BMI, and diabetes.

Results

Patients prescribed statins had higher median BMIs, were more likely to have diabetes, and had higher total cholesterol levels. Median baseline ALT levels were higher among those prescribed statins (P = 0.04) while median baseline AST levels were lower among statin users (P = 0.03). From baseline to follow-up, the median decreases in both ALT (−13.5 vs. −4.0) and AST (−4.5 vs. −0.5) were significantly larger among statin users compared to non-statin users (P = 0.03 and P = 0.0007, respectively) even after adjustment.

Conclusions

Among HCV-infected patients AST and ALT levels for those prescribed statins decreased over a 6 to 12-month follow-up period compared to patients not taking statins.

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References

  1. Kung HC, Hoyert DL, Xu JQ, et al. Deaths: final data for 2005. National vital statistics reports, vol 56, no 10. Hyattsville, MD: National Center for Health Statistics; 2008.

  2. Lloyd-Jones D, Adams R, Carnethos M, et al. Heart disease and stroke statistics—2009 update: a report from the American Heart Association statistics committee and stroke statistics subcommittee. Circulation. 2009;119:e1–e161.

    Article  Google Scholar 

  3. Centers for Disease Control and Prevention (CDC). State-specific cholesterol screening trends: United States, 1991–1999. MMWR. 2000;49:750–5.

    Google Scholar 

  4. Gotto AM. Statins: powerful drugs for lowering cholesterol. Circulation. 2002;105:1514–1516.

    Article  PubMed  Google Scholar 

  5. Pasternak RC, Smith SC, Bairey-Merz CN, et al. ACC/AHA/NHLBI clinical advisory on the use and safety of statins. JACC. 2002;3:567–572.

    Google Scholar 

  6. National Cholesterol Education Program (NCEP). Expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III) final report. Circulation. 2002;06:3143–3421.

    Google Scholar 

  7. De Denus S, Spinler SA, Miller K, et al. Statins and liver toxicity: a meta-analysis. Pharmacotherapy. 2004;24:584–591.

    Article  PubMed  Google Scholar 

  8. Khorashadi S, Hasson NK, Cheung RC. Incidence of statin hepatotoxicity in patients with Hepatitis C. Clin Gastroenterol Hepatol. 2006;4(7):902–907.

    Article  CAS  PubMed  Google Scholar 

  9. Gibson K, Rindone JP. Experience with statin use in patients with chronic hepatitis C infection. Am J Cardiol. 2005;96(9):1278–1279.

    Article  CAS  PubMed  Google Scholar 

  10. Segarra-Newnham M, Parra D, Martin-Cooper EM. Effectiveness and hepatoxicity of statins in men seropositive for hepatitis C virus. Pharmacotherapy. 2007;27(6):845–851.

    Article  CAS  PubMed  Google Scholar 

  11. Cohen DE, Anania FA, Chalasani N. An assessment of statin safety by hepatologists. Am J Cardiol. 2006;97(suppl):77C–81C.

    Article  CAS  PubMed  Google Scholar 

  12. Ye J, Wang C, Sumpter R Jr, et al. Disruption of hepatitis C virus RNA replication through inhibition of host protein geranylgeranylation. Proc Natl Acad Sci USA. 2003;100(26):15865–15870.

    Article  CAS  PubMed  Google Scholar 

  13. Kapadia SB, Chisari FV. HCV RNA replication is regulated by host geranylgeranylation and fatty acids. Proc Natl Acad Sci USA. 2005;7:2561–2566.

    Article  Google Scholar 

  14. Ikeda M, Abe K, Yamada M, et al. Different anti-HCV profiles of statins and their potential for combination therapy with interferon. Hepatology. 2006;44(1):117–125.

    Article  CAS  PubMed  Google Scholar 

  15. Bader T, Fazili J, Madhoun M, et al. Fluvastatin inhibits hepatitis C replication in humans. Am J Gastroenterol. 2008;103(6):1383–1389.

    Article  CAS  PubMed  Google Scholar 

  16. Avins AL, Manos MM, Ackerson L, et al. Hepatic effects of lovastatin exposure in patients with liver disease: a retrospective cohort study. Drug Saf. 2008;31(4):325–334.

    Article  PubMed  Google Scholar 

  17. Wackerly DD, Mendenhall W III, Scheaffer RL. Mathematical statistics with applications. Belmont, CA: Wadsworth Publishing Company, Duxbury Press; 1996.

    Google Scholar 

  18. Bhardwaj SS, Chalasani N. Lipid-lowering agents that cause drug-induced hepatotoxicity. Clin Liver Dis. 2007;11:597–613.

    Article  PubMed  Google Scholar 

  19. Onofrei MD, Butler KL, Fuke DC, et al. Safety of statin therapy in patients with preexisting liver disease. Pharmacotherapy. 2008;28(4):522–529.

    Article  CAS  PubMed  Google Scholar 

  20. Chalasani N, Aljadhey, Kesterson J, et al. Patients with elevated liver enzymes are not at higher risk for statin hepatotoxicity. Gastroenterology. 2004;126:1287–1292.

    Article  CAS  PubMed  Google Scholar 

  21. Lewis JH, Mortensen ME, Zweig S, et al. Efficacy and safety of high-dose pravastatin in hypercholesterolemic patients with well-compensated chronic liver disease: results of a prospective, randomized, double-blind, placebo-controlled, multicenter trial. Hepatology. 2007;46:1453–1463.

    Article  CAS  PubMed  Google Scholar 

  22. Mallat A, Preaux AM, Blazejewski S, et al. Effect of simvastation, an inhibitor of hydroxyl-methylglutaryl coenzyme A reductase, on the growth of human lto cells. Hepatology. 1994;20(6):1589–1594.

    Article  CAS  PubMed  Google Scholar 

  23. Rombouts K, Kisanga E, Hellemans K, et al. Effect of HMG-CoA reductase inhibitors on proliferation and protein synthesis by rat hepatic stellate cells. J Hepatol. 2003;38:564–572.

    Article  CAS  PubMed  Google Scholar 

  24. Wang C, Gale M, Keller B, et al. Identification of FBL2 as a geranylgeranylated cellular protein required for hepatitis C virus RNA replication. Mol Cell. 2005;18:425–434.

    Article  CAS  PubMed  Google Scholar 

  25. Lok AS, Everhart JE, Chung RT, et al. Evolution of hepatic steatosis in patients with advanced hepatitis C: results from the hepatitis C antiviral long-term treatment against cirrhosis (HALT-C) trial. Hepatology. 2009;49:1828–1837.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

The work was partly supported by NIH K24DK078154-03 for Dr. El-Serag, and Public Health Service Grant DK56338, which funds the Texas Medical Center Digestive Disease Center.

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Authors and Affiliations

  1. Department of Medicine, Baylor College of Medicine, Houston, TX, USA

    Louise M. Henderson, Shital Patel, Thomas P. Giordano & Hashem B. El-Serag

  2. Houston Center for Quality of Care and Utilization Studies, Health Services Research and Development Service, Department of Veterans Affairs Medical Center, Houston Veterans Affairs Medical Center (152), 2002 Holcombe Blvd, Houston, TX, 77030, USA

    Louise M. Henderson, Thomas P. Giordano & Hashem B. El-Serag

  3. Department of Pathology, Michael E. DeBakey VA Medical Center, Houston, TX, USA

    Linda Green

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  1. Louise M. Henderson
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  2. Shital Patel
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  3. Thomas P. Giordano
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  4. Linda Green
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  5. Hashem B. El-Serag
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Correspondence to Hashem B. El-Serag.

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Henderson, L.M., Patel, S., Giordano, T.P. et al. Statin Therapy and Serum Transaminases Among a Cohort of HCV-Infected Veterans. Dig Dis Sci 55, 190–195 (2010). https://doi.org/10.1007/s10620-009-0959-1

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  • DOI: https://doi.org/10.1007/s10620-009-0959-1

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