Long-term aspirin use lowers HCC risk in chronic HBV patients

Use of aspirin in the long term appears to markedly reduce the risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B virus (HBV), a study has shown.

A team of investigators analysed nationwide data on HBV-infected population in the Republic of Korea from 2010 to 2011 to identify subgroups which benefit from long-term aspirin use. Patients who had been taking aspirin for at least 3 years were classified as users.

HCC development was the primary outcome. The investigators estimated the adjusted hazard ratio (aHR) in the entire cohort using the multivariable Fine and Gray competing risk regression model. They also performed propensity score matching at a 1:4 ratio.

Over a mean follow-up of 7.5 years, 7,083 out of 161,673 patients newly developed HCC. Aspirin users (n=9,837) had a lower risk of developing HCC (entire cohort: aHR, 0.84; p=0.002; matched cohort: aHR, 0.87; p=0.010) after adjusting for age, sex, hypertension, diabetes mellitus, dyslipidaemia, cirrhosis, antivirals, metformin, statin, smoking, alcohol consumption, and obesity.

Aspirin use was significantly associated with liver-related mortality (HR, 0.79; p=0.019) but not with all-cause mortality (HR, 0.93; p=0.192). A significant association was also seen in subgroups with cirrhosis, both sexes, hypertension, nondiabetes mellitus, nonantivirals against chronic hepatitis B, nonmetformin use, nonstatin use, both smoking histories, and obesity (p<0.05 for all).

“More comprehensive studies should be implemented to clarify the causal relationship,” the investigators said.