The objective of the current study was to investigate the effect of HMG CoA Reductase Inhibitors (statins) on the development of hepatocellular cancer (HCC) in patients with hepatitis C virus (HCV) infection in the US veteran population.

VISN 16 data warehouse, which contains clinical and demographic information about all veterans (>1.4 million patients) cared for at the 10 VA Medical Centers in 4 states comprising the South Central VA health Care Network in the mid-south region of the US, was queried from October 1998 to June 2004.

Retrospective case control design was used. Multiple logistic regression analysis was used with calculation of odds ratios and 95% confidence intervals were used universally.

Results

· A total of 480,306 patients with 91.7% Men, mean age 61.1±14.8 years were queried.

· Data on race revealed 37% white and 13.3 % black.

· A total of 14,021 (2.92%) patients had HCV infection.

· HCC (ICD-9 155) was noted in 409 (0.09%) patients.

· A total of 164,250 (34.2%) were on statins.

· Patients using statins prior to diagnosis of HCC were included in the study group.

· HCV infection was a significant risk factor for the HCC prior to adjusting for statin use and after adjusting for statin use.

· Age was also a significant risk factor for HCC.

· After controlling for age and HCV infection, statin use was associated with a significant risk reduction for HCC.

Discussion

Statins are commonly used cholesterol-lowering agents that are noted to suppress tumor growth in several animal models. Studies have shown the beneficial effect of pravastatin in patients with advanced HCC. However clinical data for a chemoprotective role of statins against HCC is lacking.

An internal consistency of the database is reflected by an increased risk associated with documented risk factors.

The results should be interpreted with caution given the limitations of population, the database and retrospective design. Furthermore, dose, duration and nature of particular medication were not factored into the analysis.

In conclusion, the authors write, “Statin use was found to have a significant protective effect against hepatocellular cancer after controlling for age and hepatitis C virus infection.”

V Khurana and others. Statins Are Protective Against Hepatocellular Cancer in Patients With Hepatitis C Virus Infection: Half a Million Us Veterans' Study Abstract S1535. DDW 2005. May 14-18, 2005. Chicago, IL.