How Does Statin Use Affect the Liver in Patients with HIV/HCV?

Individuals who initiate statins have a lower risk of 18-month acute liver injury (ALI) and mortality vs statin nonusers, regardless of human immunodeficiency virus (HIV) and/or chronic hepatitis C virus (HCV) status, according to a recent study.

Patients with HIV and/or chronic HCV may be treated with statins for metabolic or cardiovascular disease. However, it is unknown whether the risk for ALI is higher among statin initiators vs nonusers based on HIV/HCV status.
______________________________________________________________________________________

RELATED CONTENT
Hepatitis C Treatment Is Safe, Effective in Some HIV Patients
AASLD Hepatitis C Guidelines Now Include Newer Antivirals
______________________________________________________________________________________

For their study, the researchers assessed individuals with HIV/HCV coinfection (n = 7686), HCV infection alone (n = 8155), HIV infection alone (n = 17,739), or no infection (n = 36,604) who had been enrolled in the 2000-2012 Veterans Aging Cohort Study.

Eighteen-month liver aminotransferases of more than 200 U/L, severe ALI, and mortality were calculated. Severe ALI was defined as coagulopathy with hyperbilirubinemia. Propensity score-adjusted hazard ratios were calculated with 95% confidence intervals via Cox regression in order to compare outcomes in statin initiators with those of nonusers across each group.

Results indicated that statin initiators had lower risks of aminotransferase levels of less than 200 U/L, severe ALI, and mortality, compared with statin nonusers. Among those with HCV infection alone, statin use was associated with decreased risks of aminotransferase elevations, severe ALI, and mortality vs nonusers. Among individuals with HIV alone, statin use was associated with decreased risks for aminotransferase increases, severe ALI, and mortality, compared with nonusers.

The researchers noted that results were similar among individuals with no infection.

“Regardless of HIV and/or chronic HCV status, statin initiators had a lower risk of ALI and death within 18 months compared with statin nonusers,” the researchers concluded.

—Christina Vogt

Reference:

Byrne DD, Tate JP, Forde KA, et al. Risk of acute liver injury after statin initiation by human immunodeficiency virus and chronic hepatitis C virus infection status. Clin Infect Dis. 2017;65(9):1542-1550. https://doi.org/10.1093/cid/cix564.