Use of H1 antihistamines and risk of hepatocellular carcinoma in patients with hepatitis B virus, hepatitis C virus, or dual infection

By Matthew Stenger

Posted: 02/15/2022 11:11:00 AM

Last update: 02/15/2022 12:39:33

In a Taiwanese study published in the Journal of Clinical OncologyShen et al found that the use of H1 antihistamines was associated with a reduced risk of hepatocellular carcinoma in patients with hepatitis B virus (HBV), hepatitis C virus (HCV), or HBV/HCV dual infection.

Study details

The study involved data on 521,071 HBV-infected, 169,159 HCV-infected, and 39,016 infected patients from the Taiwan National Health Insurance Research Database for the period of January 2006 to December 2015. Antihistamine use was assessed as a time-varying covariate in the analysis. . The cumulative antihistamine dose was calculated by multiplying the number of pills dispensed by the prescribed dose and dividing the value by the days supply recorded. Antihistamine use was defined by cumulative defined daily dose (cDDD) – i.e. the sum of the prescribed daily dose, non-users of antihistamines with a cDDD

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Main conclusions

In the matched HBV cohort, the incidence rate of hepatocellular carcinoma for antihistamine users versus nonusers was 198.35 versus 426.03 per 100,000 person-years. In the analysis adjusted for age, gender and comorbidities, the risk of hepatocellular carcinoma was significantly lower in antihistamine users (adjusted relative risk [HR] = 0.489, 95% CI = 0.455–0.524). A dose-response relationship between the use of antihistamines and the risk of hepatocellular carcinoma was observed, with adjusted hazard ratios of 0.597 (95% CI = 0.530 to 0.674), 0.528 (95% CI = 0.465 to 0.600), 0.470 (95% CI = 0.416–0.531) and 0.407 (95% CI = 0.362–0.457) for 28 to 42, 43 to 63, 64 to 119 and ≥ 120 cDDD vs no antihistamine use.

In the matched HCV cohort, the incidence rate of hepatocellular carcinoma for users versus nonusers was 651.26 versus 1,334.80 per 100,000 person-years. In adjusted analysis, the risk of hepatocellular carcinoma was significantly lower in users (adjusted HR = 0.484, 95% CI = 0.450-0.522). A dose-response relationship between the use of antihistamines and the risk of hepatocellular carcinoma was observed, with adjusted hazard ratios of 0.537, 0.518, 0.479 and 0.425 for 28 to 49, 50 to 84, 85 to 168 and ≥ 169 cDDD.

In the dual infection cohort, the incidence rate of hepatocellular carcinoma for users versus nonusers was 1,059.31 versus 2,165.81 per 100,000 person-years. In an adjusted analysis, the risk of hepatocellular carcinoma was significantly reduced in users (adjusted HR = 0.469, 95% CI = 0.416–0.529). As with the other cohorts, a dose-response relationship was observed, with adjusted hazard ratios of 0.588, 0.514, 0.415, and 0.394 for cDDDs of 28-49, 50-84, 85-168, and ≥169.

The researchers concluded: “The use of antihistamines may reduce the risk of hepatocellular carcinoma in patients with HBV, HCV, or dual infection in a dose-dependent manner. Further mechanistic research is needed.

Chi-Ching Chang, Ph.D.of the Division of Allergy, Immunology and Rheumatology, Faculty of Medicine, Taipei Medical University, is the corresponding author of the Journal of Clinical Oncology item.

Disclosure: The study was supported by grants from the Republic of China Ministry of Science and Technology and Taipei Medical University Hospital. For full disclosures from the study authors, visit ascopubs.org.

The content of this article has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the views and opinions of ASCO®.