Atorvastatin in Combination with Pegylated Interferon and Ribavirin Provided High Rate of Sustained Virological Response in Patients with Genotype 3 Hepatitis C Virus

Abstract

BACKGROUND: Chronic hepatitis C virus infection represents a more frequent cause of liver cirrhosis and hepatocellular carcinoma. Statins, inhibit HCV replication in vitro, enhance the antiviral effect of the already known antiviral drugs and reduce their resistance.
 AIM: To determine the impact of additional therapy (treatment with Atorvastatin 20 mg) to the standard antiviral therapy (pegylated interferon alpha-peg-IFN α and ribavirin) on achieving sustained virological response (SVR).
 MATERIAL AND METHODS: In the study which is comparative, open-label, prospective-retrospective, 70 patients diagnosed with chronic hepatitis C virus infection who met criteria for treatment with standard antiviral therapy combined with anti-lipemic therapy (Atorvastatin 20 mg) were included. Patients in the study were divided into two groups: one group of 35 patients receiving combination therapy (Atorvastatin + peg-IFN α + Ribavirin) and another group of 35 patients received only standard antiviral therapy. Those parameters were followed in all patients: genotyping, quantification of the virus, histological assessment of liver inflammation and fibrosis degree (before starting treatment), the presence of steatosis, laboratory analysis: hematology, liver, lipid and carbohydrate status, insulin blood level (the calculation of HOMA-IR) and body mass index (BMI) calculation. The overall treatment of the patients depends from the virus genotype, thus, patients with genotype 1 and 4 received 48 weeks standard antiviral therapy, but patients with genotypes 2 and 3 received 24 weeks of antiviral therapy. SVR was considered an undetectable level of HCV RNA levels 24 weeks after completion of antiviral therapy. The results were statistically analysed, and all results for p < 0.05 were considered statistically significant.
 RESULTS: Combination therapy leads to a slightly higher percentage of SVR (85.71%) in patients with chronic hepatitis C versus standard therapy (74.29%), but in a group of patients with genotype 3 this rate of SVR amounting to 95.83%. Combination therapy leads to significant improvement of lipid and glucose status after treatment, and in terms of side effects, there was no appearance of serious adverse events that would be a reason for discontinuation of the therapy.
 CONCLUSION: Combination therapy Atorvastatin + pegylated interferon alpha + Ribavirin leads to high rate of SVR of 95.83% in patients with chronic hepatitis C, genotype 3. Statins can be used safely in patients with chronic hepatitis C.

Atorvastatin therapy in COVID-19 adult inpatients: A double-blind, randomized controlled trial

“…By running MTT assay & hemagglutination endpoint test, significant anti-influenza properties of atorvastatin in cell culture were ascertained, which may interfere with inhibition of the early stage of virus replication [10] . A previous study has shown that combination therapy with atorvastatin + interferon pegylated alpha + ribavirin results in a high sustained virological response rate (SVR) of 95.83% in patients with genotype 3 chronic hepatitis C, and as a result, statin therapy can be performed with high safety in patients with chronic hepatitis C [11] . The Current guideline for the treatment of COVID-19 inpatients in Iran includes the administration of lopinavir/ritonavir (kaletra) [12] , but atorvastatin has not been tested in hospitalized patients.…”

A Dual Pharmacological Strategy against COVID-19: The Therapeutic Potential of Metformin and Atorvastatin

“…ATO suppresses HCV replication and has synergistic action with interferon. Additionally, it is associated with a 49% reduction in the incidence of hepatocellular carcinoma [69][70][71][72].…”

Plausible Positive Effects of Statins in COVID-19 Patient

“…This evidence has been supported by some studies that have shown that statins may have some antiviral potential against HCV. In fact, statins have been shown to have antireplicative viral activity against HCV when used in association with interferon [74][75][76]. By reducing the availability of cholesterol, statins may represent possible candidates to interfere with virus fusion and entry into host cells [77].…”