The benefit of statins in chronic hepatitis C patients: a systematic review and meta-analysis

Background and aim Besides regulating lipid metabolism, statins have garnered considerable interest because of their antiviral and antineoplastic properties. The potential benefit of statins using in chronic hepatitis C (CHC) patients is not well described. This meta-analysis was carried out to quantitatively assess the efficacy of statins in improving the therapeutic effect and prognosis of patients with CHC. Patients and methods We searched electronic databases for relevant studies comparing the course of benefit in CHC patients with statins versus without statins. Risk estimates were pooled to assess the association of statins use with sustained virological response and the prognosis of CHC patients. Results Twenty-three studies fulfilled the inclusion criteria. Meta-analysis of 16 homogeneous studies showed that the sustained virological response rate increased by 31% [relative risk (RR) = 1.31; 95% confidence interval (CI): 1.23-1.39] in 12 791 CHC patients with statins as an adjuvant under the general antiviral therapy compared with those without this adjuvant therapy. Moreover, meta-analysis of seven studies suggested that statins was beneficial on several specific poor outcomes of CHC patients (RR= 0.49; 95% CI: 0.42-0.56). CHC patients with statin use were found to be inversely associated with a 55% reduced risk of hepatocellular carcinoma (RR= 0.45; 95% CI: 0.36-0.57) and 53% reduced risk of cirrhosis (RR= 0.47; 95% CI: 0.33-0.67) as well as 44% reduced risk of mortality (RR= 0.56; 95% CI: 0.46-0.69). However, significant heterogeneity and publication bias were present in some of our analyses. Conclusion Beneficial effects of statins use were found in the therapy and the prognosis of CHC patients. Further prospective studies are still needed to confirm these benefits. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.