People with hepatitis B virus (HBV) who took
an aspirin a day – often recommended to help prevent cardiovascular disease –
had a lower risk of developing liver cancer, according to a study from Taiwan presented
at the 2017 AASLD Liver Meeting this week in Washington,
"For effectively preventing HBV‐related liver cancer,
the findings of this study may help hepatologists treat patients with chronic
HBV infection in the future, particularly for those who are not indicated for
antiviral therapy," said lead researcher Teng-Yu Lee of Taichung Veterans General Hospital.
years or decades, chronic hepatitis B or C, heavy alcohol use, fatty liver
disease and other causes of liver injury can lead to the development of
cirrhosis and hepatocellular carcinoma (HCC), a type of primary liver cancer.
- hepatocellular carcinoma (HCC)
Liver cancer. A long-term complication of chronic inflammation of the liver or cirrhosis.
antiviral therapy using nucleoside/nucleotide
analogues such as tenofovir (Viread
or Vemlidy) or entecavir (Baraclude) has been shown to reduce –
although not completely eliminate – the risk of liver cancer, but many people
with chronic hepatitis B are not considered eligible for this treatment.
Lee's team sought to determine whether there is an
association between aspirin therapy and HBV-related liver cancer risk.
Often prescribed as a pain reliever, aspirin also has
anti-inflammatory properties and inhibits blood clotting. Taking a low-dose
aspirin each day is recommended
for the prevention of cardiovascular disease and colon cancer in older adults, but there is little research about its
effect on liver cancer.
This study looked at a nationwide cohort using medical
records from the Taiwan National Health Insurance Research Database between
1998 and 2012. The researchers screened 204,507 people with chronic hepatitis B,
excluding those with other types of viral hepatitis.
The analysis included 1553 people who had used
continuous daily aspirin therapy for at least three months, averaging nearly
four years. They were matched by age and sex with four people who did not regularly
take aspirin (totalling 6212 control subjects).
About three quarters were men and the average age was
54 years. About 5% had liver cirrhosis and under 10% were treated with
nucleoside/nucleotide analogues. Pre-existing cardiovascular disease and risk
factors such as diabetes and high blood pressure were more common in the
The incidence of liver cancer among people taking
daily aspirin was significantly lower than the rate in the non-aspirin group.
While about 3% of people in the aspirin group developed HCC over five years, this
rose to about 6% in the non-aspirin group.
Aspirin therapy was associated with a 37% reduction in
the risk of HCC in a multivariate analysis controlling for other factors (hazard
ratio [HR] 0.63). Other independent risk factors for liver cancer included male
sex (HR 2.65), older age (HR 1.03 per year), cirrhosis (HR 1.89) and diabetes
(HR 1.51), while use of statins and nucleoside/nucleotide analogues were associated
with a lower risk (HR 0.57 for each).
Based on these results, the researchers concluded, "Aspirin therapy
was significantly associated with a reduced risk of HCC in patients with
chronic hepatitis B."