Statins may inhibit hepatitis C virus, study says

Statins prevent the hepatitis C virus from replicating -- a phenomenon that was amplified when combined with other drugs used to treat this disease, according to a study published in the July Hepatology. The authors hope their findings will lead to the use of these medications for HCV-infected patients, either as a booster of current regimens or as a substitute for treatments that may cause significant side effects.

"Many patients need more effective anti-hepatitis C therapy to prevent the progress of the disease," said Dr. Masanori Ikeda, the study's lead author and a professor in the department of molecular biology at Okayama University Graduate School of Medicine in Japan.

Researchers tested the activity of statin drugs against HCV in cell cultures, finding that fluvastatin had the most dramatic effect and lovastatin the least.

Experts found the conclusions intriguing because, if this result is further replicated in other studies, it could lead to a new use for drugs that are already widely available and provide additional options for the 45% of patients who are not helped by current therapies.

"When you look at something, you never know what you're going to find," said Norman Sussman, MD, a hepatologist and associate professor of medicine and surgery at Baylor College of Medicine in Houston. "Things show up in the strangest places. You've got to always keep an open mind."

More research needed

Physicians, however, said it is too early to start prescribing these drugs to treat patients with hepatitis C. The study only analyzed statins' impact on the virus in the test-tube environment, and it's unclear what the effect would be on patients.

"I'm not sure that we really understand that mechanism of how this may work," said Adrian Di Bisceglie, MD, a hepatologist and professor of internal medicine at Saint Louis University. "But there's enough here to take it to the next step. It's worth doing a study to see if the level of virus goes down in humans."

But while many are intrigued, significant doubts also exist regarding whether statins can give the extra punch many feel is needed to increase the effectiveness of hepatitis C treatments. Also, these existing drugs are expected to be overshadowed by newer antivirals in development.

"It's very good that the statins may have some effect, but it seems like it's sending a boy to do a man's job," said David Nash, MD, a cardiologist and clinical professor at the State University of New York Upstate Medical Center in Syracuse. He has written about the use of these drugs in patients with both high cholesterol levels and hepatitis C.

Easing some concerns

Hope continues, though, that studies such as this one will make physicians more comfortable using statin drugs in patients with hepatitis C who also have cholesterol problems.

"Our patients with hepatitis C are discriminated against and kept from drugs that could prevent heart disease because pretty much all of the statin drugs say use with caution in people with liver disease," said Dr. Di Bisceglie. "Anything that further demonstrates the safety of the statins is a great thing. We are very confident in using them in those with liver disease. It's our everyday practice, and we feel quite comfortable doing it."