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Statin drugs decrease progression to cirrhosis in HIV/HCV co-infected individuals.

Statin drugs decrease progression to cirrhosis in HIV/HCV co-infected individuals.
Author Information (click to view)

Oliver NT, Hartman CM, Kramer JR, Chiao EY,


Oliver NT, Hartman CM, Kramer JR, Chiao EY, (click to view)

Oliver NT, Hartman CM, Kramer JR, Chiao EY,

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AIDS (London, England) 2016 8 3()

Abstract
INTRODUCTION
Chronic HIV/HCV co-infection carries increased risk of cirrhosis, hepatocellular carcinoma, and death. Due to anti-inflammatory properties, HMG co-A inhibitors (statins) may be useful adjunctive therapy to reduce liver disease progression.

METHODS
Clinical information was extracted from the Veterans Affairs HIV and HCV Clinical Case Registries (1999 – 2010). HIV-related variables included combination anti-retroviral therapy (cART) era of diagnosis, CD4 cell count, and percent time with undetectable HIV viral load. Metabolic variables included diabetes, low-HDL, and hypertension. Statin use was measured as percent time with active prescription (time-updated throughout the follow-up period). Cox proportional hazards analysis was used to determine risk factors for cirrhosis (ICD-9 or APRI>2) overall and in groups stratified by alanine aminotransferase (ALT) level above and below 40 IU/L.

RESULTS
The cohort included 5985 HIV/HCV co-infected veterans. The majority was black race, and the mean age at index date was 45 years. Statin use was significantly protective of cirrhosis for patients with ALT ≤40 IU/L; for every 30% increase in time on statin, there was a 32% decreased risk of developing cirrhosis (HR 0.68, 95% CI 0.47 -0.98). Diabetes and low-HDL were significantly associated with cirrhosis in patients with ALT > 40 IU/L (HR 1.15, p < 0.04 and HR 1.3, p < 0.0001). CONCLUSIONS
Statin drug use is beneficial in mitigating the risk of liver disease progression for HIV/HCV co-infected patients without advanced liver disease. Low-HDL and diabetes in co-infected patients with abnormal ALT have greater risk of cirrhosis development.

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