PDF(Pubmed)
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.
摘要：
背景：抗组胺药对癌症风险和预后的影响在所有癌症中都不一致。这项多中心队列研究的目的是调查抗组胺药的使用与病毒性肝炎患者肝癌风险之间的关系。方法：这项多中心队列研究包括2008年1月至2022年3月之间诊断为乙型肝炎或丙型肝炎的个体。对于抗组胺药治疗的患者，索引日期是抗组胺药处方的日期，对于非用户，那是肝炎诊断的日期。参与者被跟踪了五年，感兴趣的主要结果是新发肝癌。计算发生率和校正后的风险比（aHR）及其结果的95％置信区间（CI）。进行了亚组分析，按包括丙型肝炎和乙型肝炎在内的病毒性肝炎类型进行分层。结果：本研究共纳入7748例病毒性肝炎患者。在使用抗组胺药的病毒性肝炎患者中，发病率为12.58/1000人年，相比之下，没有使用抗组胺药的人每1000人年为3.88。在调整了包括年龄在内的因素后，性别,体重指数（BMI），合并症,肝功能检查的实验室数据，喜剧,以及抗病毒治疗的使用，使用抗组胺药的患者新发肝癌的风险显著较高(aHR=1.83,95%CI,1.28~2.60).在丙型肝炎患者中，抗组胺药组的发病率为15.73/1000人年，而非使用者的比率为每1000人年4.79。使用抗组胺药的丙型肝炎患者患肝癌的风险明显更高（aHR=3.24，95％CI，2.16-4.86）。结论：这项多中心队列研究报道了抗组胺药治疗的乙型肝炎或丙型肝炎患者肝癌风险增加。需要长期随访研究来验证这些发现。
