4.6 Article

Drug-induced liver injury: Asia Pacific Association of Study of Liver consensus guidelines

Journal

HEPATOLOGY INTERNATIONAL
Volume 15, Issue 2, Pages 258-282

Publisher

SPRINGER
DOI: 10.1007/s12072-021-10144-3

Keywords

APASL; DILI; Consensus; Guidelines; Hepatotoxicity; Drug-induced liver injury; Medications; Risk factors; Tuberculosis; Antituberculosis drugs; Monitoring; Treatment; Traditional and complimentary medicine

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Idiosyncratic drug-induced liver injury, common in Asia, may be due to hepatotoxicity from tuberculosis treatment and the widespread use of traditional and complimentary medicine in Asian countries. The consequences of this type of liver injury can range from asymptomatic to severe, often lacking pathognomonic diagnostic serological markers, highlighting the need for awareness and early detection.
Idiosyncratic drug-induced liver injury mimics acute and chronic liver disease. It is under recognized and underrecognised because of the lack of pathognomonic diagnostic serological markers. Its consequences may vary from being asymptomatic to self-limiting illness to severe liver injury leading to acute liver failure. Its incidence is likely to be more common in Asia than other parts of the world, mainly because of hepatotoxicity resulting from the treatment of tuberculosis disease and the ubiquitous use of traditional and complimentary medicines in Asian countries. This APASL consensus guidelines on DILI is a concise account of the various aspects including current evidence-based information on DILI with special emphasis on DILI due to antituberculosis agents and traditional and complementary medicine use in Asia.

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