title: Aspirin may reduce liver fibrosis progression: Evidence from a multicenter retrospective study of recurrent hepatitis C after liver transplantation.
abstract: OBJECTIVE
  There is evidence for an association between thrombosis in the hepatic microcirculation and liver fibrosis. The aim of this study was to evaluate the role of daily low-dose aspirin (75 or 100mg, given for prevention of hepatic artery thrombosis) in fibrosis progression to ≥ F2 fibrosis score in liver-transplant recipients with recurrent hepatitis C virus (HCV).
  
  
  METHODS
  All HCV-positive patients who had undergone liver transplantation (LT) between 2000 and 2010 were included. Exclusion criteria were negative HCV RNA, previous LT or death within a year of LT. Liver fibrosis was assessed by histological evaluation. Data were censored at the date of the last histological evaluation before starting anti HCV therapy. Progression to fibrosis F ≥ 2 was analyzed with a multistate model with time-dependent covariables.
  
  
  RESULTS
  One hundred and eighty-eight patients were included. In univariate analysis, older recipient and donor age, male donor gender, activity score ≥ A2 after LT, number of steroid boluses and aspirin intake (HR: 0.75 [0.57-0.97]; P=0.03) influenced the risk of progression to fibrosis ≥ F2. In multivariate analysis, adjusted on site, older donor age, male donor gender, activity score ≥ A2 and number of steroids boluses, remained independent predictors of fibrosis progression, while younger recipient age and aspirin intake (HR: 0.65 [0.47-0.91]; P=0.01) were associated with a slower fibrosis progression.
  
  
  CONCLUSIONS
  Low-dose aspirin treatment might be associated with a lower risk of liver fibrosis progression in patients with HCV recurrence after LT.
authors.affiliation: Service d'hépatologie, hôpital Saint-Antoine, 184, rue du faubourg Saint-Antoine, 75012 Paris, France. Electronic address: armelle.poujol-robert@sat.aphp.fr.
authors.forename: Armelle
authors.initials: A
authors.lastname: Poujol-Robert
authors.affiliation: Service de santé publique, hôpital Saint-Antoine, AP-HP, Paris, France.
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Boëlle
authors.affiliation: Centre de transplantation hépatique, hôpital Saint-Antoine, AP-HP, Paris, France.
authors.forename: Filomena
authors.initials: F
authors.lastname: Conti
authors.affiliation: Service d'hépatologie et réanimation hépatodigestive, hôpital Beaujon, AP-HP, Clichy, France.
authors.forename: François
authors.initials: F
authors.lastname: Durand
authors.affiliation: Service d'hépato-gastroentérologie, hôpital Henri-Mondor, AP-HP, Créteil, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Duvoux
authors.affiliation: Service d'anatomie et de cytologie pathologiques, hôpital Saint-Antoine, AP-HP, Paris, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Wendum
authors.affiliation: Département d'anatomie pathologique, hôpital Beaujon, AP-HP, Clichy, France.
authors.forename: Valérie
authors.initials: V
authors.lastname: Paradis
authors.affiliation: Secteur de virologie, service de microbiologie, hôpital Beaujon, AP-HP, Clichy, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Mackiewicz
authors.affiliation: Service d'hépatologie, hôpital Saint-Antoine, 184, rue du faubourg Saint-Antoine, 75012 Paris, France; UMR S938, faculté de médecine Pierre-et-Marie-Curie, site Saint-Antoine, Paris, France; Université Pierre-et-Marie-Curie (UPMC) Paris 6, Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Chazouillères
authors.affiliation: Service d'hépatologie, hôpital Saint-Antoine, 184, rue du faubourg Saint-Antoine, 75012 Paris, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Corpechot
authors.affiliation: Service d'hépatologie, hôpital Saint-Antoine, 184, rue du faubourg Saint-Antoine, 75012 Paris, France.
authors.forename: Raoul
authors.initials: R
authors.lastname: Poupon
mesh_terms: D001241:Aspirin / Q000627:therapeutic use*; D018450:Disease Progression; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D008103:Liver Cirrhosis / Q000188:drug therapy* / Q000209:etiology*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000188:drug therapy* / Q000209:etiology*; D012008:Recurrence; D012189:Retrospective Studies
chemical_list: D001241:Aspirin