Antihistamines May Reduce Risk of Hepatocellular Carcinoma in Patients With Viral Hepatitis

A new study showed a reduced risk of hepatocellular carcinoma (HCC) in patients with viral hepatitis who used H1-antihistamines (AHs), compared with those who did not. The results were published in the Journal of Clinical Oncology.

The researchers noted that, although H1-AHs are most commonly used to treat allergic reactions and mast cell-mediated disorders, preclinical evidence has suggested they may exert protective effects against cancer.

The researchers conducted a retrospective study to investigate the association of H1-AH use with the risk of HCC in patients with hepatitis B virus (HBV), hepatitis C virus (HCV), or dual HBV-HCV virus infection.

The study included 729,246 patients from Taiwan’s National Health Insurance Research Database who were examined between January 1, 2006, and December 31, 2015. There were 521,071 patients with HBV infection, 169,159 with HCV infection, and 39,016 with dual HBV-HCV infection.

Each of the 3 cohorts was split evenly into AH users (defined as those who had more than 28 cumulative defined daily doses) and AH non-users (those with less than 28 cumulative defined daily doses).

There was a significantly lower risk of HCC among patients who used AHs compared with patients who did not. This was true for patients with HBV (adjusted hazard ratio [aHR], 0.49; 95% CI, 0.46-0.52), HCV (aHR, 0.48; 95% CI, 0.45-0.52), or dual HBV-HCV infection (aHR, 0.47; 95% CI, 0.42-0.53).

The researchers observed a dose-response relationship between AH use and the risk of HCC in the HBV, HCV, and dual HBV-HCV cohorts.

The use of nonaspirin nonsteroidal anti-inflammatory drugs and statins was also associated with a lower risk of HCC in the HBV and HCV cohorts.

In contrast, comorbidities such as cirrhosis, diabetes mellitus, and hypertension were associated with a higher risk of HCC in all 3 cohorts. Men had a higher risk of HCC compared with women in the HBV (aHR, 2.35; 95% CI, 2.16-2.57) and HCV (aHR, 1.44; 95% CI, 1.34-1.55) cohorts.

“AH use could be a potential adjuvant strategy for preventing HCC in patients with HBV, HCV, or dual infections,” the researchers concluded.

Reference

Shen Y-C, Hsu H-C, Lin T-M, et al. H1-antihistamines reduce the risk of hepatocellular carcinoma in patients with HBV, HCV, or dual HBV-HCV infection. J Clin Oncol. Published online January 19, 2022. doi:10.1200/JCO.21.01802