***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Hepatitis C viral ( HCV ) infection is the leading cause of death due to liver disease in the United States . Currently , pegylated interferon and ribavirin produce sustained viral remission in only 50 % of patients . Additional agents are needed to increase the cure rate . In vitro experiments show strong antiviral effects of fluvastatin against HCV . OBJECTIVES : To assess the safety and antiviral effects of fluvastatin in chronic HCV carriers . METHODS : 31 veterans with chronic HCV were prospect ively given oral doses of fluvastatin , 20 to 320 mg/day , for 2–12 weeks with weekly monitoring of HCV RNA and liver tests . Reductions of viral load ( P < 0.01 ) versus a control group were considered suppressive . RESULTS : With 80 mg a day or less , 11/22 ( 50 % ) patients responded by lowering HCV RNA . The first lowering occurred within 4 weeks ( 9/11 , 82 % ) . The greatest weekly change in HCV RNA level was a 1.75 log10 reduction . When lowered in responders , the viral load remained relatively constant for 2–5 weeks ( 7/9 , 78 % ) , or on the next test rebounded immediately to a non-significant change from , baseline ( n = 2 ) . Continued lowering of virus was seen in 2/19 ( 22 % ) patients when the study ended . We found no evidence of liver tests worsening . CONCLUSIONS : FLV used as monotherapy in vivo showed suppressive effects of HCV clinical ly that are modest , variable , and often short-lived . These findings support “ proof-of-concept ” for pilot trials combining fluvastatin with st and ard therapy . Statins and fluvastatin , in particular , appear to be safe for use in hepatitis BACKGROUND & AIMS Simvastatin improves liver generation of nitric oxide and hepatic endothelial dysfunction in patients with cirrhosis , so it could be an effective therapy for portal hypertension . This r and omized controlled trial evaluated the effects of continuous simvastatin administration on the hepatic venous pressure gradient ( HVPG ) and its safety in patients with cirrhosis and portal hypertension . METHODS Fifty-nine patients with cirrhosis and portal hypertension ( HVPG > or = 12 mm Hg ) were r and omized to groups that were given simvastatin 20 mg/day for 1 month ( increased to 40 mg/day at day 15 ) or placebo in a double-blind clinical trial . R and omization was stratified according to whether the patient was being treated with beta-adrenergic blockers . We studied splanchnic and systemic hemodynamics and variables of liver function and safety before and after 1 month of treatment . RESULTS Simvastatin significantly decreased HVPG ( -8.3 % ) without deleterious effects in systemic hemodynamics . HVPG decreases were observed in patients who were receiving beta-adrenergic blockers ( -11.0 % ; P = .033 ) and in those who were not ( -5.9 % ; P = .013 ) . Simvastatin improved hepatic , fractional , and intrinsic clearance of indocyanine green , showing an improvement in effective liver perfusion and function . No significant changes in HVPG and liver function were observed in patients receiving placebo . The number of patients with adverse events did not differ significantly between groups . No patient was withdrawn from the study based on adverse events . CONCLUSIONS Simvastatin decreased HVPG and improved liver perfusion in patients with cirrhosis . These effects were additive with those of beta-adrenergic blockers . The beneficial effects of simvastatin should be confirmed in long-term clinical trials for portal hypertension BACKGROUND Pleiotropic effects of statins decrease intrahepatic resistance and portal hypertension . AIM We evaluated the effects of simvastatin on hepatic venous pressure gradient ( HVPG ) and azygos vein blood flow in cirrhotic patients . METHODS A 3-month prospect i ve , r and omized , triple-blind trial with simvastatin ( 40 mg/day ) vs. placebo was conducted in patients with cirrhotic portal hypertension . HVPG and azygos blood flow , measured by colour Doppler endoscopic ultrasound , were assessed before and after treatment . The primary endpoint was a decrease in the HVPG of at least 20 % from baseline or to ≤12 mmHg after the treatment . RESULTS 34 patients were prospect ively enrolled , and 24 completed the protocol . In the simvastatin group 6/11 patients ( 55 % ) presented a clinical ly relevant decrease in the HVPG ; no decrease was observed in the placebo group ( p=0.036 ) . Patients with medium/large oesophageal varices and previous variceal bleeding had a higher response rate to simvastatin  . HVPG and azygos blood flow values were not correlated . No significant adverse events occurred . CONCLUSION Simvastatin  lowers portal pressure and may even improve liver function . The haemodynamic effect appears to be more evident in patients with severe portal hypertension 
    Output:
    
In summary , statin use is associated with a decreased incidence rate of cirrhosis and is most pronounced in Eastern countries but also in Western countries