Statin (3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitor)-based therapy for hepatitis C virus (HCV) infection-related diseases in the era of direct-acting antiviral agents.
Recent improvements have been made in the treatment of hepatitis C virus (HCV) infection with the introduction of direct-acting antiviral agents (DAAs). However, despite successful viral clearance, many patients continue to have HCV-related disease progression. Therefore, new treatments must be developed to achieve viral clearance and prevent the risk of HCV-related diseases. In particular, the use of pitavastatin together with DAAs may improve the antiviral efficacy as well as decrease the progression of liver fibrosis and the incidence of HCV-related hepatocellular carcinoma. To investigate the management methods for HCV-related diseases using pitavastatin and DAAs, clinical trials should be undertaken. However, concerns have been raised about potential drug interactions between statins and DAAs. Therefore, pre-clinical trials using a replicon system, human hepatocyte-like cells, human neurons and human cardiomyocytes from human-induced pluripotent stem cells should be conducted. Based on these pre-clinical trials, an optimal direct-acting antiviral agent could be selected for combination with pitavastatin and DAAs. Following the pre-clinical trial, the combination of pitavastatin and the optimal direct-acting antiviral agent should be compared to other combinations of DAAs (e.g., sofosbuvir and velpatasvir) according to the antiviral effect on HCV infection, HCV-related diseases and cost-effectiveness.
Medical Biotechnology Lab, Microbial Biotechnology Department, National Research Center, Egypt, Cairo, Egypt.
Sara Sobhy
SS
Kishta
Department of Surgery, Theodor Bilharz Research Institute, Giza, Egypt.
Sobhy Ahmed
SA
Kishta
Medical Biotechnology Lab, Microbial Biotechnology Department, National Research Center, Egypt, Cairo, Egypt.
Reem
R
El-Shenawy
HCV infection-related diseases; Hepatitis C virus (HCV) infection; direct-acting antiviral agents (DAAs); human hepatocyte-like cells from human induced pluripotent stem cells; replicon system; statins