title: Lipid dysregulation in hepatitis C virus, and impact of statin therapy upon clinical outcomes.
abstract: The hepatitis C virus (HCV) is one of the most common causes of chronic liver disease and the leading indication for liver transplantation worldwide. Every aspect of the HCV life cycle is closely tied to human lipid metabolism. The virus circulates as a lipid-rich particle, utilizing lipoprotein cell receptors to gain entry into the hepatocyte. It has also been shown to upregulate lipid biosynthesis and impair lipid degradation, resulting in significant intracellular lipid accumulation and circulating hypocholesterolemia. Patients with chronic hepatitis C (CHC) are at increased risk of hepatic steatosis, fibrosis, and cardiovascular disease including accelerated atherosclerosis. HMG CoA Reductase inhibitors, or statins, have been shown to play an important role in the modulation of hepatic steatosis and fibrosis, and recent attention has focused upon their potential therapeutic role in CHC. This article reviews the hepatitis C viral life cycle as it impacts host lipoproteins and lipid metabolism. It then describes the pathogenesis of HCV-related hepatic steatosis, hypocholesterolemia and atherosclerosis, and finally describes the promising anti-viral and anti-fibrotic effects of statins, for the treatment of CHC.
authors.affiliation: Tracey G Simon, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, United States.
authors.forename: Tracey G
authors.initials: TG
authors.lastname: Simon
authors.affiliation: Tracey G Simon, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115, United States.
authors.forename: Adeel A
authors.initials: AA
authors.lastname: Butt
mesh_terms: D000818:Animals; D000998:Antiviral Agents / Q000627:therapeutic use*; D050171:Dyslipidemias / Q000175:diagnosis / Q000188:drug therapy* / Q000821:virology; D016174:Hepacivirus / Q000187:drug effects* / Q000254:growth & development; D019698:Hepatitis C, Chronic / Q000145:classification / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology; D016896:Treatment Outcome; D014779:Virus Replication / Q000187:drug effects
chemical_list: D000998:Antiviral Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Cholesterol; Cirrhosis; Fibrosis; Hepatitis C virus; Lipid profiles; Statin