Human drug hepatotoxicity: a contemporary clinical perspective

Abstract

Background: Drug-induced liver injury (DILI) constitutes a significant medical challenge. The rising number of marketed drugs, aging population and polypharmacy make it imperative to understand the clinical presentation of DILI and the processes used in the assessment of causality and early detection. Objective: This article reviews the current clinical understanding of DILI including presentation patterns, causality assessment, risk factor ascertainment and early detection strategies including liver test monitoring. Significant initiatives such as the Drug-Induced Liver Injury Network (DILIN) are also discussed. Methods: A narrative review of clinical studies of DILI, with emphasis on clinical features, causality and surveillance. Conclusion: DILI remains a serious challenge in contemporary clinical practice. Further research and collaboration in the areas of epidemiology, causality and early detection are required to enhance the diagnosis and management of DILI.

Keywords::

• causality assessment
• DILI
• DILIN
• drug hepatotoxicity
• early detection
• RUCAM