HIGH PREVALENCE OF DILI/HILI IN A CENTER PARTICIPATING IN A MULTICENTER STUDY FOR DIAGNOSING ACUTE HEPATITIS IN BRAZIL

IF 4.4 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Annals of hepatology Pub Date : 2025-09-01 DOI:10.1016/j.aohep.2025.102037

Tayna da Silva Domingos , Vinicius Santos Nunes , Luiz Antônio Rodrigues de Freitas , Sidelcina Rugeri Pacheco , Raymundo Paraná Ferreira Filho , Maria Isabel Schinoni

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引用次数: 0

Abstract

Introduction and Objectives

Hepatotoxicity caused by drugs and herbs (DILI/HILI) can cause mild to severe lesions. The diagnosis is based on exclusion, and it is essential to investigate the use of drugs and herbal remedies.

To assess the prevalence of DILI/HILI in a multicenter study on acute hepatitis.

Materials and Methods

A cross-sectional, descriptive, and analytical study conducted at a university hospital in Bahia, as part of a national multicenter screening project for acute hepatitis. Patients with clinical suspicion of acute hepatitis were included.

Results

The sample included 50 patients: 17 (34%) with DILI/HILI and 33 (66%) with other etiologies. These included: autoimmune hepatitis 4 (8%), cholestatic syndrome 1(2%), late transplant rejection 1(2%), Chikungunya and Dengue 2(4%), alcoholic hepatitis 1(2%), Caroli syndrome 1 (2%), and biliary cholangiopathy 1(2%). Viral etiologies: hepatitis B 6 (12%), including one case of chronic HBV reactivated by herbal use, hepatitis C 3 (6%), Epstein-Barr virus IgM 5 (10%), and Cytomegalovirus IgM 3 (6%), with one CMV case in the DILI/HILI group. Thirteen cases (26%) had undefined or non-hepatic causes. Two groups were stratified: Group 1 with DILI/HILI (17) and Group 2 without DILI/HILI (33). Median values were calculated for ALT, AST, ALP, GGT, and bilirubin total. Group 1: AST 257 U/L, ALT 313 U/L, GGT 696 U/L, ALP 234 U/L, BT 7.6 mg/dL. Group 2: AST 162 U/L, ALT 109 U/L, GGT 216 U/L, ALP 172 U/L, TB 4.9 mg/dL. AST, ALT, and GGT were higher in the DILI/HILI group. No statistical difference in ALP and BT (p=0.5120; p=0.8057).

Conclusions

DILI/HILI cases showed a more prominent biochemical profile, suggesting more severe liver injury. Careful investigation of drug and herbal use is essential in the evaluation of acute hepatitis.

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在巴西参与急性肝炎诊断多中心研究的一个中心，帝力/ hili的高流行率

药物和草药引起的肝毒性（DILI/HILI）可引起轻至重度病变。诊断是基于排除，调查药物和草药的使用是至关重要的。在一项急性肝炎多中心研究中评估DILI/HILI的患病率。材料和方法在巴伊亚州一所大学医院进行的一项横断面、描述性和分析性研究，作为国家急性肝炎多中心筛查项目的一部分。纳入临床怀疑为急性肝炎的患者。结果50例患者中，DILI/HILI患者17例（34%），其他病因33例（66%）。其中包括：自身免疫性肝炎4（8%）、胆汁淤积综合征1（2%）、晚期移植排斥1（2%）、基孔肯雅热和登革热2（4%）、酒精性肝炎1（2%）、Caroli综合征1（2%）和胆道胆管病1（2%）。病毒病因：乙型肝炎6(12%)，包括1例用草药重新激活的慢性HBV，丙型肝炎3 (6%)，eb病毒IgM 5（10%）和巨细胞病毒IgM 3 (6%)， DILI/HILI组中有1例巨细胞病毒。13例（26%）病因不明或非肝性。分为两组：有DILI/HILI的1组（17例）和无DILI/HILI的2组（33例）。计算ALT、AST、ALP、GGT和总胆红素的中位数。第1组：AST 257 U/L， ALT 313 U/L, GGT 696 U/L, ALP 234 U/L, BT 7.6 mg/dL。第二组：AST 162 U/L， ALT 109 U/L, GGT 216 U/L, ALP 172 U/L, TB 4.9 mg/dL。DILI/HILI组AST、ALT、GGT升高。ALP与BT无统计学差异（p=0.5120; p=0.8057）。结论dili /HILI患者的生化特征更为突出，表明肝损伤更为严重。在评估急性肝炎时，仔细调查药物和草药的使用是必要的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of hepatology 医学-胃肠肝病学

CiteScore

7.90

自引率

2.60%

发文量

183

审稿时长

4-8 weeks

期刊介绍： Annals of Hepatology publishes original research on the biology and diseases of the liver in both humans and experimental models. Contributions may be submitted as regular articles. The journal also publishes concise reviews of both basic and clinical topics.