Impact of Added Fluvastatin to Standard-of-Care Treatment on Sustained Virological Response in Naïve Chronic Hepatitis C Patients Infected with Genotypes 1 and 3

Kurinčič, Tanja Selič; Lešničar, Gorazd; Poljak, Mario; Volkar, Jelka Meglic; Rajter, Mojca; Prah, J.; Baklan, Zvonko; Kotar, Tadeja; Matičič, Mojca

doi:10.1159/000354541

Cited by 15 publications

(4 citation statements)

References 34 publications

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“…In one analysis of patients with HCV 1-3 genotypes who received combination therapy with PEG-IFN/Rbv, the significant impact of statin use was only observed among the HCV G1 patients. [20] Similar findings were reported by Kurincic et al [21] Steatosis is a common histologic finding in patients infected by HCV G3, independently of the presence of fibrosis, diabetes, hepatic inflammation, ongoing alcohol abuse, higher body mass index and older age [22]. Indeed, steatosis in HCV G3 infected patients is not the result of overexpression of genes involved in lipogenesis.…”

Section: Editorialsupporting

confidence: 77%

HCV genotype 3: a wolf in sheep’s clothing

Blanco

Rivero‐Juárez

2016

Expert Review of Anti-infective Therapy

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Section: Editorialsupporting

confidence: 77%

HCV genotype 3: a wolf in sheep’s clothing

Blanco

Rivero‐Juárez

2016

Expert Review of Anti-infective Therapy

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“…This genotype variability has not yet been adequately studied, given the fact that most clinical studies to date have been conducted on patients infected with HCV genotype 1 [ (Kondo et al, 2012) (Kohjima et al, 2013)]. A recent prospective study investigating treatment efficacy of added FLV to PEG-IFN/RBV therapy in genotype 1 and genotype 3 patients reported no significant increase in SVR rates in the genotype 3 patient population, in contrast to genotype 1 patients with a high viral load, indicating that the antiviral efficacy of statins may indeed be genotype-dependent (Kurincic et al, 2014).…”

Section: Ii) Prospective Studiesmentioning

confidence: 99%

Are statins a viable option for the treatment of infections with the hepatitis C virus?

Verpaalen

Neyts

2014

Antiviral Research

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Statins are 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors that are widely used for the treatment of hypercholesterolemia. Besides their cholesterol-lowering effect, statins have been reported to have antiviral activity against a variety of viruses, including hepatitis C virus (HCV). Several statins inhibit the in vitro replication of subgenomic HCV replicons and also suppress in vitro RNA replication of infectious HCV. The precise mechanism of the anti-HCV activity of statins has not yet been defined. Recent studies suggest that the antiviral effect may result from the inhibition of geranylgeranylation of cellular proteins, rather than the inhibition of cholesterol synthesis. Despite the antiviral effect observed in vitro, statin monotherapy seems to be insufficient for the treatment of chronic HCV infection. However, several prospective and retrospective studies have demonstrated that the addition of statins to IFN-α and ribavirin therapy increases SVR, RVR, and EVR rates without the occurrence of additional adverse events. These clinical data, together with the excellent safety profile and low cost, suggest that statins may play a role in HCV therapy until more potent and safe direct-acting antivirals become available. This article forms part of a symposium in Antiviral Research on "Hepatitis C: next steps toward global eradication."

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“…Most studies have analysed the effect of Fluvastatin on the virologic response, and the number of studies that analysed other statins is lower. There are studies that are potentiating the positive impact of Fluvastatin as an additional therapy of standard antiviral therapy over virologic response, especially for genotype 1, such as the study of Selic Kurincic et al, [31]. The study of Atsukawa et al, [32], showed the reduction of viral relapse in patients with genotype 1b, as well as the studies of Georgescu et al, [33], Sesaki et al, [34] and Kondo et al, [35].…”

Section: Discussionmentioning

confidence: 99%

Atorvastatin in Combination with Pegylated Interferon and Ribavirin Provided High Rate of Sustained Virological Response in Patients with Genotype 3 Hepatitis C Virus

Todorovska¹,

Caloska-Ivanova²,

Dimitrova-Genadieva³

et al. 2019

Open Access Maced J Med Sci

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BACKGROUND: Chronic hepatitis C virus infection represents a more frequent cause of liver cirrhosis and hepatocellular carcinoma. Statins, inhibit HCV replication in vitro, enhance the antiviral effect of the already known antiviral drugs and reduce their resistance. AIM: To determine the impact of additional therapy (treatment with Atorvastatin 20 mg) to the standard antiviral therapy (pegylated interferon alpha-peg-IFN α and ribavirin) on achieving sustained virological response (SVR). MATERIAL AND METHODS: In the study which is comparative, open-label, prospective-retrospective, 70 patients diagnosed with chronic hepatitis C virus infection who met criteria for treatment with standard antiviral therapy combined with anti-lipemic therapy (Atorvastatin 20 mg) were included. Patients in the study were divided into two groups: one group of 35 patients receiving combination therapy (Atorvastatin + peg-IFN α + Ribavirin) and another group of 35 patients received only standard antiviral therapy. Those parameters were followed in all patients: genotyping, quantification of the virus, histological assessment of liver inflammation and fibrosis degree (before starting treatment), the presence of steatosis, laboratory analysis: hematology, liver, lipid and carbohydrate status, insulin blood level (the calculation of HOMA-IR) and body mass index (BMI) calculation. The overall treatment of the patients depends from the virus genotype, thus, patients with genotype 1 and 4 received 48 weeks standard antiviral therapy, but patients with genotypes 2 and 3 received 24 weeks of antiviral therapy. SVR was considered an undetectable level of HCV RNA levels 24 weeks after completion of antiviral therapy. The results were statistically analysed, and all results for p < 0.05 were considered statistically significant. RESULTS: Combination therapy leads to a slightly higher percentage of SVR (85.71%) in patients with chronic hepatitis C versus standard therapy (74.29%), but in a group of patients with genotype 3 this rate of SVR amounting to 95.83%. Combination therapy leads to significant improvement of lipid and glucose status after treatment, and in terms of side effects, there was no appearance of serious adverse events that would be a reason for discontinuation of the therapy. CONCLUSION: Combination therapy Atorvastatin + pegylated interferon alpha + Ribavirin leads to high rate of SVR of 95.83% in patients with chronic hepatitis C, genotype 3. Statins can be used safely in patients with chronic hepatitis C.

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Impact of Added Fluvastatin to Standard-of-Care Treatment on Sustained Virological Response in Naïve Chronic Hepatitis C Patients Infected with Genotypes 1 and 3

Cited by 15 publications

References 34 publications

HCV genotype 3: a wolf in sheep’s clothing

HCV genotype 3: a wolf in sheep’s clothing

Are statins a viable option for the treatment of infections with the hepatitis C virus?

Atorvastatin in Combination with Pegylated Interferon and Ribavirin Provided High Rate of Sustained Virological Response in Patients with Genotype 3 Hepatitis C Virus

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