Drug-induced liver injury

Lack of substantial advances in pre-clinical testing for hepatotoxicity has meant that drug-induced liver injury (DILI) remains an important issue during both the drug development and post-marketing phases. A number of drug-related, genetic and non-genetic host factors influence the risk of DILI in any individual.

The identification of specific HLA genotypes plays a major role in drug-induced liver injury (DILI). Research shows that the adaptive immune system contributes significantly to its development. Genetic variations in drug metabolism enzymes also increase susceptibility to certain types of DILI. These variations affect how drugs are processed, leading to toxic metabolites that harm the liver. Early detection of symptoms, such as jaundice or fatigue, is crucial. Immediate withdrawal of the drug prevents further damage and reduces the risk of liver failure. Timely intervention remains the best approach to managing DILI and preventing severe complications.

Diagnosis of DILI relies upon index of suspicion, careful evaluation of a temporal relationship between the exposure to a particular drug and the specific clinical event, and exclusion of potential alternative diagnoses. A high negative predictive value of genetic tests can be used to rule out DILI caused by particular drugs and to correctly identify the agent underlying DILI in a patient exposed to two concomitant medications.

Keywords for Drug-induced liver injury

Adverse drug reactiondrug-induced liver injuryhepatotoxicityhuman leukocyte antigenMRCPpharmacogenetics

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