Association of Aspirin with Hepatocellular Carcinoma and Liv
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Although the incidences of hepatocellular carcinoma and liver-related death are reduced with hepatitis B viral suppression or hepatitis C eradication, they nonetheless persist in high-risk patients, including those with advanced fibrosis. Thus, an urgent need remains to develop effective strategies to prevent hepatocellular carcinoma and reduce mortality from cirrhosis.

Experimental and clinical data suggest that aspirin may prevent progression of liver disease and hepatocarcinogenesis through diverse potential mechanisms including prevention of platelet degranulation, modulation of bioactive lipids, and inhibition of the proinflammatory cyclooxygenase-2 (COX-2) enzyme.

These findings extend previous data linking aspirin to a reduced risk of hepatocellular carcinoma, including studies focused on duration of therapy. The study population consisted of 50,275 adults (13,276 with hepatitis B and 36,999 with hepatitis C), including 14,205 aspirin users and 36,070 nonusers.

In conclusion, in a nationwide population of persons with chronic viral hepatitis, low-dose aspirin use was associated with a duration-dependent significantly lower risk of incident hepatocellular carcinoma and liver-related death than no use of aspirin, without a significantly higher risk of gastrointestinal bleeding. Our findings support the need for randomized clinical trials designed to test the benefits of aspirin for primary prevention of hepatocellular carcinoma.

Source: https://www.nejm.org/doi/full/10.1056/NEJMoa1912035?query=featured_home
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