Multidisciplinary expert consensus on clinical features and prognosis of drug-induced liver injury

AIM: To analyze the clinical features of druginduced liver injury (DILI), and discuss the risk factors affecting its prognosis. METHODS: Clinical data for 572 patients with DILI hospitalized at the First Affiliated Hospital of Xi’an Jiaotong University, the Second Affiliated Hospital of Xi’an Jiaotong University and Xijing Hospital from 2010 to 2014 were retrospectively analyzed. Gender, age, underlying disease, medication time, clinical manifestation, clinical classification, type of drugs, laboratory tests, ways of medication, treatments and prognosis were analyzed to explore the risk factors affecting the prognosis. RESULTS: A total of 572 patients were involved, including 280 (48.95%) males and 292 (51.05%) females, and their average age was 45.56 ± 15.11 years. Most cases of DILI occurred in less than 8 weeks of medication. Main clinical manifestations were jaundice (59.44%), fatigue (57.52%), and poor appetite (55.54%). Four hundred and two (70.28%) cases were classified as hepatocellular type, 62 (10.84%) cases as cholestasis type and 53 (9.27%) as mixed type. The top three most common types of drugs that induced DILI were Chinese herbs, antituberculotics and antimicrobials. As for the prognosis, 194 cases were cured, 323 cases improved well, 39 cases showed no significant improvement, and 16 cases died. Factors influencing prognosis of DILI were medication time, clinical classification, type of drugs and index of total bilirubin, with total bilirubin being an independent risk factor for DILI. CONCLUSION: Clinical manifestations of drug-induced liver injury are non-specific. The most common cause is Chinese medicine. There are many factors influencing DILI, with total bilirubin being the independent risk factor.