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Communication

Treatment with Antihistamines and the Risk of Liver Cancer in Patients with Viral Hepatitis: A Multi-Center Cohort Study

1
Department of Internal Medicine, Weiss Memorial Hospital/University of Illinois, Chicago, IL 60640, USA
2
Department of Medicine, National Cheng Kung University, Tainan 701401, Taiwan
3
Division of Infectious Diseases, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung 402306, Taiwan
4
School of Medicine, Chung Shan Medical University, Taichung 402306, Taiwan
5
Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
*
Authors to whom correspondence should be addressed.
Viruses 2024, 16(6), 940; https://doi.org/10.3390/v16060940
Submission received: 17 May 2024 / Accepted: 4 June 2024 / Published: 11 June 2024
(This article belongs to the Special Issue Pharmacology of Antivirals Targeting Metabolism and Immunity)

Abstract

Background: The effects of antihistamines on cancer risk and prognosis have been inconsistent across cancers. The aim of this multi-center cohort study was to investigate the association between antihistamine use and the risk of liver cancer in individuals with viral hepatitis. Methods: This multi-center cohort study included individuals diagnosed with hepatitis B or hepatitis C between January 2008 and March 2022. For antihistamine-treated patients, the index date was the date of antihistamine prescription, and for non-users, it was the date of hepatitis diagnosis. Participants were followed for five years, with the primary outcome of interest being new-onset liver cancer. The incidence rate and the adjusted hazard ratio (aHR) along with its 95% confidence interval (CI) of the outcome were calculated. Subgroup analyses were conducted, stratified by types of viral hepatitis including hepatitis C and hepatitis B. An additional validation study was performed. Results: The study included a total of 7748 patients with viral hepatitis. The incidence rate was 12.58 per 1000 person-years in patients with viral hepatitis on antihistamines, compared to 3.88 per 1000 person-years in those without antihistamine use. After adjusting for factors including age, sex, body mass index (BMI), comorbidities, laboratory data of liver function tests, comedications, and the use of antiviral therapies, the risk of new-onset liver cancer was significantly higher in patients on antihistamines (aHR = 1.83, 95% CI, 1.28–2.60). In patients with hepatitis C, the incidence rate in the antihistamine group was 15.73 per 1000 person-years, while non-users had a rate of 4.79 per 1000 person-years. Patients with hepatitis C on antihistamines had a significantly higher risk of developing liver cancer (aHR = 3.24, 95% CI, 2.16–4.86). Conclusions: This multi-center cohort study reported an increased risk of liver cancer in patients with hepatitis B or hepatitis C treated with antihistamines. Long-term follow-up studies are warranted to validate the findings.
Keywords: viral hepatitis; antihistamine; liver cancer; hepatitis C viral hepatitis; antihistamine; liver cancer; hepatitis C

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MDPI and ACS Style

Chan, S.-Y.; Chang, Y.; Polpichai, N.; Lee, Y.-T.; Ma, K.S.-K. Treatment with Antihistamines and the Risk of Liver Cancer in Patients with Viral Hepatitis: A Multi-Center Cohort Study. Viruses 2024, 16, 940. https://doi.org/10.3390/v16060940

AMA Style

Chan S-Y, Chang Y, Polpichai N, Lee Y-T, Ma KS-K. Treatment with Antihistamines and the Risk of Liver Cancer in Patients with Viral Hepatitis: A Multi-Center Cohort Study. Viruses. 2024; 16(6):940. https://doi.org/10.3390/v16060940

Chicago/Turabian Style

Chan, Shu-Yen, Yushan Chang, Natchaya Polpichai, Yuan-Ti Lee, and Kevin Sheng-Kai Ma. 2024. "Treatment with Antihistamines and the Risk of Liver Cancer in Patients with Viral Hepatitis: A Multi-Center Cohort Study" Viruses 16, no. 6: 940. https://doi.org/10.3390/v16060940

APA Style

Chan, S.-Y., Chang, Y., Polpichai, N., Lee, Y.-T., & Ma, K. S.-K. (2024). Treatment with Antihistamines and the Risk of Liver Cancer in Patients with Viral Hepatitis: A Multi-Center Cohort Study. Viruses, 16(6), 940. https://doi.org/10.3390/v16060940

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