Signatures in drug-induced liver injury

Tillmann, Hans L.; Rockey, Don C.

doi:10.1097/mog.0000000000000636

Cited by 8 publications

(6 citation statements)

References 40 publications

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“…Besides methylprednisolone, other drugs such as antibiotics, arbidol, lopinavir/ritonavir, interferon, and ribavirin may also cause liver injury. [21][22][23] Most of the patients enrolled in this study received these drugs. No differences were observed in the use of these drugs between patients with and without liver injury except for interferon atomization therapy, which was given more to patients with liver injury.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of Liver Function in Patients With SARS-CoV-2 and Chronic HBV Coinfection

Zou

Fang

et al. 2021

Clinical Gastroenterology and Hepatology

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BACKGROUND & AIMS: Coronavirus disease 2019 (COVID-19) is a major global health threat. We aimed to describe the characteristics of liver function in patients with SARS-CoV-2 and chronic hepatitis B virus (HBV) co-infection. METHODS: We enrolled all adult patients with SARS-CoV-2 and chronic HBV co-infection admitted to Tongji Hospital from February 1 to February 29, 2020. Data of demographic, clinical characteristics, laboratory tests, treatments, and clinical outcomes were collected. The characteristics of liver function and its relation with the severity and prognosis of disease were described. RESULTS: Of 105 SARS-CoV-2 and chronic HBV co-infected patients, elevated levels of liver test were seen in several patients at admission, including elevated levels of alanine aminotransferase (22, 20.95%), aspartate aminotransferase (29, 27.62%), total bilirubin (7, 6.67%), gamma-glutamyl transferase (7, 6.67%), and alkaline phosphatase (1, 0.95%). The values of the indices mentioned above increased substantially during hospitalization (all P < .05). Fourteen (13.33%) patients developed liver injury. Most of them (10, 71.43%) recovered after 8 (range 6-21) days. Notably, 4 (28.57%) patients rapidly progressed to acute-on-chronic liver failure. The proportion of severe COVID-19 was higher in patients with liver injury (P [ .042). Complications including ACLF, acute cardiac injury and shock happened more frequently in patients with liver injury (all P < .05). The mortality was higher in individuals with liver injury (28.57% vs 3.30%, P [ .004). CONCLUSION: Liver injury in patients with SARS-CoV-2 and chronic HBV co-infection was associated with severity and poor prognosis of disease. During the treatment of COVID-19 in chronic HBVinfected patients, liver function should be taken seriously and evaluated frequently.

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Section: Discussionmentioning

confidence: 99%

Characteristics of Liver Function in Patients With SARS-CoV-2 and Chronic HBV Coinfection

Zou

Fang

et al. 2021

Clinical Gastroenterology and Hepatology

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“…On the other hand, drug-related liver injury is a key factor that cannot be ignored. Many COVID-19 patients have been treated with antibiotics and antivirals, which are toxic to the liver and may cause abnormal liver function [39].…”

Section: Discussionmentioning

confidence: 99%

Effects of Hepatitis B Virus Infection on Patients with COVID-19: A Meta-Analysis

Xing-zhao

Wan

2022

Dig Dis Sci

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Background The COVID-19 pandemic has brought new problems to patients infected with hepatitis B virus (HBV). Aim We aim to know the effects of HBV infection on patients with COVID-19. Methods We searched PubMed, Embase, and Web of Science for data and utilized Stata 14.0 software for this meta-analysis with a random-effects model. This paper was conducted in alignment with the preferred reporting items for systematic review and meta-analysis (PRISMA) guideline. Results In total, 37,696 patients were divided into two groups: 2591 COVID-19 patients infected with HBV in the experimental group and 35,105 COVID-19 patients not infected with HBV in the control group. Our study showed that the in-hospital mortality of the experimental group was significant higher than that of the control group (OR = 2.04, 95% CI 1.49-2.79). We also found that COVID-19 patients infected with HBV were more likely to develop severe disease (OR = 1.90, 95% CI 1.32-2.73) than COVID-19 patients not infected with HBV. Upon measuring alanine aminotransferase (SMD = 0.62, 95% CI 0.25-0.98), aspartate aminotransferase (SMD = 0.60, 95% CI 0.30-0.91), total bilirubin (SMD = 0.45, 95% CI 0.23-0.67), direct bilirubin (SMD = 0.36, 95% CI 0.24-0.47), lactate dehydrogenase (SMD = 0.32, 95% CI 0.18-0.47), we found that HBV infection led to significantly higher laboratory results in COVID-19 patients. Conclusion COVID-19 patients infected with HBV should receive more attention, and special attention should be given to various liver function indices during treatment.

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“…Table 3 shows that each IBD drug causes its own typical liver injury, also known as ‘signature’. Differences in drug signatures are most strikingly related to differences in latency and biochemical injury pattern [ 19 ].…”

Section: Step 4: Discontinue the Potentially Implicated Drug?mentioning

confidence: 99%

Managing abnormal liver tests in children with inflammatory bowel disease

Rheenen

2021

Current Opinion in Pediatrics

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Purpose of review Liver test abnormalities in children with inflammatory bowel disease (IBD) are usually insidious in onset. By the time that symptoms referable to liver disease have appeared, the liver injury may be well advanced. It is, therefore, important that children with an incidental finding of abnormal liver tests are investigated in an appropriate and timely manner. Recent findings The most prevalent cause of liver test elevations in paediatric IBD is immune-related liver disease, including primary sclerosing cholangitis, autoimmune sclerosing cholangitis, and autoimmune hepatitis. Although less common, drugs used in the treatment of IBD can also cause liver injury. The diagnosis of drug-induced liver injury relies largely on excluding other causes of liver injury, such as viral hepatitis, nonalcoholic fatty liver disease, and biliary and vascular complications. Summary This review highlights an avenue to a step-wise approach for investigating children with IBD and silent liver test elevations. Central to the timing of diagnostic actions is grading the severity of liver test elevations.

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Signatures in drug-induced liver injury

Cited by 8 publications

References 40 publications

Characteristics of Liver Function in Patients With SARS-CoV-2 and Chronic HBV Coinfection

Characteristics of Liver Function in Patients With SARS-CoV-2 and Chronic HBV Coinfection

Effects of Hepatitis B Virus Infection on Patients with COVID-19: A Meta-Analysis

Managing abnormal liver tests in children with inflammatory bowel disease

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