Zhiguo Li1, Ying Li1, Xiaoke Li2, Ludan Zhang1, Nanqi Zhao3, Hongbo Du2, Bo Zhou4, Yong'an Ye2. 1. Department of Gastroenterology, Beijing Fengtai Hospital of Integrated Traditional and Western Medicine, Beijing, China; Beijing University of Chinese Medicine, Beijing, China. 2. Department of Gastroenterology, Beijing Fengtai Hospital of Integrated Traditional and Western Medicine, Beijing, China; Institute of Liver Diseases, Beijing University of Chinese Medicine, Beijing, China. 3. Beijing University of Chinese Medicine, Beijing, China; Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China. 4. Beijing University of Chinese Medicine, Beijing, China.
Abstract
BACKGROUND: Hepatocellular carcinoma is the world's leading cause of cancer-related death. Chronic hepatitis B virus and hepatitis C virus infection cause liver cancer. The aim of this study was to investigate the relationship between statins and the risk of hepatocellular carcinoma in patients with hepatitis B or C. METHODS: We systematically searched Web of Science, Embase, PubMed, Cochrane Library, China National Knowledge Infrastructure, and Wanfang Database from their inception to January 2019. We included studies that reported the hepatocellular carcinoma incidence among hepatitis B virus- or hepatitis C virus-infected patients or hepatitis B virus- or hepatitis C virus-related cirrhotic patients, evaluated and clearly defined exposure to statins, provided effective comparison groups, and reported risk estimates. Inclusion was not otherwise restricted. Summary relative risk estimates with 95% CIs were calculated using a random-effects model. RESULTS: Meta-analysis of 10 studies showed that statin users had a significantly lower risk of hepatocellular carcinoma (relative risk = 0.47, 95% CI = 0.38-0.56) with significant heterogeneity. In 7 hepatitis studies, using statin was associated with a 53% reduction in the incidence of hepatocellular carcinoma (relative risk = 0.47, 95% CI = 0.43-0.50) with substantial heterogeneity. In 3 cirrhosis studies, the incidence of hepatocellular carcinoma in statin users was significantly reduced by 55% (relative risk = 0.45, 95% CI = 0.30-0.61) with no heterogeneity. CONCLUSION: Statins reduce the hepatocellular carcinoma risk among patients infected with hepatitis B virus or hepatitis C virus. This chemoprotective association is more pronounced in hepatitis B virus or hepatitis C virus-associated cirrhotic patients.
BACKGROUND: Hepatocellular carcinoma is the world's leading cause of cancer-related death. Chronic hepatitis B virus and hepatitis C virus infection cause liver cancer. The aim of this study was to investigate the relationship between statins and the risk of hepatocellular carcinoma in patients with hepatitis B or C. METHODS: We systematically searched Web of Science, Embase, PubMed, Cochrane Library, China National Knowledge Infrastructure, and Wanfang Database from their inception to January 2019. We included studies that reported the hepatocellular carcinoma incidence among hepatitis B virus- or hepatitis C virus-infected patients or hepatitis B virus- or hepatitis C virus-related cirrhotic patients, evaluated and clearly defined exposure to statins, provided effective comparison groups, and reported risk estimates. Inclusion was not otherwise restricted. Summary relative risk estimates with 95% CIs were calculated using a random-effects model. RESULTS: Meta-analysis of 10 studies showed that statin users had a significantly lower risk of hepatocellular carcinoma (relative risk = 0.47, 95% CI = 0.38-0.56) with significant heterogeneity. In 7 hepatitis studies, using statin was associated with a 53% reduction in the incidence of hepatocellular carcinoma (relative risk = 0.47, 95% CI = 0.43-0.50) with substantial heterogeneity. In 3 cirrhosis studies, the incidence of hepatocellular carcinoma in statin users was significantly reduced by 55% (relative risk = 0.45, 95% CI = 0.30-0.61) with no heterogeneity. CONCLUSION: Statins reduce the hepatocellular carcinoma risk among patients infected with hepatitis B virus or hepatitis C virus. This chemoprotective association is more pronounced in hepatitis B virus or hepatitis C virus-associated cirrhotic patients.
Authors: Jorge A Marrero; Laura M Kulik; Claude B Sirlin; Andrew X Zhu; Richard S Finn; Michael M Abecassis; Lewis R Roberts; Julie K Heimbach Journal: Hepatology Date: 2018-08 Impact factor: 17.425