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Statin use reduces risk for cirrhosis, decompensation in HBV

Statin use was associated with a decreased risk for developing cirrhosis and decompensation in Taiwanese patients with chronic hepatitis B virus infection, according to published findings.

“This large population-based study in a hepatitis B virus endemic country suggested that statins independently protect [chronic hepatitis B] patients from the development of cirrhosis, its complications and its decompensation according to a dose–response relationship,” Yi-Wen Huang, MD, PhD, of the Liver Center, Cathay General Hospital Medical Center, Taiwan, and colleagues wrote.

Yi-Wen Huang

The researchers analyzed data of 298,761 patients with chronic HBV found in the Taiwanese National Health Insurance Research Database between 1997 and 2009. Of these, 6,543 were using statins and were matched in a 1 to 1 ratio propensity score and inception point-matched patients in a cohort of non-statin users. Researchers followed these patients from the start of statin use until cirrhosis or decompensation developed, until a patient withdrew from insurance or through December 2009.

After adjustment for competing mortality, researchers found that patients with chronic HBV using statins had a lower cumulative incidence of cirrhosis (RR = 0.43; 95% CI, 0.34–0.51) and decompensated cirrhosis (RR = 0.46; 95% CI, 0.34–0.63) compared with patients who did not use statins.

Further analysis using a Cox proportional hazard model indicated statins were still independently associated with lower risk for cirrhosis (adjusted HR = 0.51; 95% CI, 0.41–0.63) and decompensation (adjusted HR = 0.53; 95% CI, 0.43–0.65), after adjusting for numerous variables including age, sex, comorbidity index and obesity.

The adjusted HRs for cirrhosis was also lower in patients receiving triglyceride-lowering drugs; 0.46 for between 91 and 365 cumulative daily doses and 0.2 for greater than 365 daily doses; and the adjusted HRs for decompensated cirrhosis were 0.61 between 91 and 365 cumulative daily doses and 0.23 for greater than 365 daily doses. The cumulative defined daily doses of triglyceride lipid-lowering drugs showed a dose–response relationship at greater than 365 cumulative defined daily doses.

The researchers concluded: “Statins independently reduce cirrhosis and its decompensation in chronic hepatitis B patients. This protective effect was stronger with higher dosage and longer duration of statin use,” the researchers concluded. – by Melinda Stevens

Disclosure: The researchers report no relevant financial disclosures.