Can statins cure HCV Group 1

1
Can statins cure HCV? Group 1

• Introduction Several in vitro studies let us
  show that cholesterol biosynthesis plays an
  important role in HCV replication.
• The aim of our studie is to investigate wheter
  the reduction of cholesterol blood levels reduce
  viral load in vivo.
• Methods The studie took place at the
  Massachusetts general Hospital Hepatology Clinic
  form10.02.06 till 29.03.06. We prospectively
  enrolled 10 patients with chronic HCV and
  elevated cholesterol levels. All were tested to
  confirm HCV viremia with the Cobas Amplicor HCV
  monitor Test. All patients received 20 mg
  Atorvastatine daily for 12 weeks. We evaluated
  the HCV RNA and the cholesterol levels after 4
  and 12 weeks. 2 patients were lost in follow-up.
• Results Patients experienced a significant drop
  in total cholesterol and LDL at the end of the
  study. However we found no siginificant change in
  the HCV RNA level after 4 and 12 weeks.
• Conclusion According to our study atorvastatine
  at conventional dose was effective at lowering
  cholesterol but not in lowering the HCV RNA
  level.
• The presented results require deeper studies with
  larger study groups.

2
The antiviral effect of atorvastatin in patients
with HCV a pilot studygroup 2

• Introduction Cholesterol biosynthesis has been
  shown to be essential for HCV RNA replication.
  HMG- CoA reductase inhibitors block HCV RNA
  replication in vitro. Therefore, this study aims
  to determine whether the antiviral activity of
  atorvastatin could be observed in vivo.
• Methods A prospective clinical pilot study was
  performed on 10 patients (aged 30-80) with
  chronic HCV and cholesterol levels which met
  treatment criteria. 20 mg atorvastatin was
  administered daily for 12 weeks. Data on HCV RNA,
  liver function tests and creatine kinase where
  collected at week 4 and 12. Cholesterol levels
  before and following treatment were also
  measured. Power calculations were performed prior
  to study. Data was analysed using Students t
  test, and Wilcoxon rank sum test.
• Results 8/10 patients were available for follow
  up. When compared to pretreatment HCV RNA levels,
  no significant change was detected in week 4 and
  12. A significant drop in total cholesterol
  (p0.003) and LDL (plt 0.0001) following 12 weeks
  was observed. The median ALT levels did not
  change during treatment period.
• Conclusion Atorvastatin at conventional doses
  does not have an antiviral effect on HCV in a 12
  week treatment trial. Further studies to
  determine the role of cholesterol and lipid
  metabolism inhibitors as adjuncts to HCV therapy
  are necessary

3
Does atorvastatin have an antiviral effect on HCV
infected patients? (group 3)

• Introduction and aims In an effort to develop
  novel treatments for HCV, attention as been
  focused on the requisite elements of HCV RNA
  replication. Several studies have shown that
  cholesterol biosynthesis is essential for HCV RNA
  replication and that HMG-CoA reductase inhibitors
  block HCV RNA replication in vitro. The aim of
  our pilot study is to determine whether antiviral
  activity of statins could be observed in vivo.
•  
• Methods We prospectively enrolled 10patients
  with chronic HCV from our clinic, from February
  to march 2006. All were tested to confirm HCV
  viremia. The enroled patients were men and women
  between 30 and 80 years of age who meet treatment
  criteria for elevated cholesterol as defined by
  the 2004 national cholesterol education program.
  All persons had an HCV load and lipid panel prior
  to initiation of atorvastatin. All patients were
  started on 20 mg atorvastatin nightly and
  continued for 12 weeks. Patients had HCV RNA,
  aminotransferases, bilirubin, alkaline
  phosphatise, and creatine kinase evaluations at 4
  and 12 weeks. The statistical methods used were
  Student t test and Wilcoxon rank sum test.
•  
• Results The patients mean age was 50.5, 70 of
  patients were male, and 80 were infected with
  genotype 1. The mean total cholesterol was
  235mg/dl. Patients experienced a statistically
  significant drop in total cholesterol and LDL
  after 12 weeks of therapy. We compared
  pretreatment HCV RNA levels to week 12 HCV RNA
  levels and founs no significanr change(p-NS)
•  
• Conclusion