Previous studies have found that statins can have pleiotropic effects, including potential chemoprevention. Some observational studies have found that statins may prevent hepatocellular carcinoma (HCC), but their use has not been fully studied in patients with chronic hepatitis B virus (HBV) infection. The authors conducted a hospital-based retrospective cohort study of 7713 chronic HBV-infected patients. The primary outcome was the development of HCC. They defined patients who used statins for at least 28 cumulative defined daily doses (cDDD) during the follow-up period as statin users (n = 713). During a median follow-up of 7.2 years, HCC newly developed in 9.1% of patients. The authors found that statin use was associated with a significantly lower risk of HCC (adjusted hazard ratio [aHR] 0.36, 95%CI 0.19-0.68; adjusted for age, sex, cirrhosis, diabetes, hypertension, serum alanine aminotransferase, cholesterol, HBV DNA level, antiviral treatment and antiplatelet therapy). This observed benefit of statin use was dose dependent (aHR 0.63, 95%CI 0.31-1.29 for 28-365 cDDDs; aHR 0.51, 95%CI 0.21-1.25 for 366-730 cDDDs; aHR 0.32, 95%CI 0.07–1.36 for 731-1095 cDDDs; and aHR 0.17, 95%CI 0.06–0.48 for ≥1095 cDDDs). Therefore statin use appears to be associated with a reduced risk of HCC development in chronically HBV-infected patients.
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