Abstract:
Introduction. Drug induced liver injury (DILI) is a relatively rare hepatic condition as a result of the use
of illegal drugs, herbal products, dietary supplements, medications or other xenobiotics. It occurs in
susceptible subject through a combination of genetic and environmental risk factors believed to modify
drug metabolism and/or excretion leading to a cascade of cellular events, including oxidative stress
formation, apoptosis/necrosis, haptenization, immune response activation and a failure to adapt. Liver
toxicity related to drugs has been classically divided into two varieties: intrinsic and idiosyncratic. The
intrinsic is dose related and occurs after exposure, the idiosyncratic does not correlate with the dose,
Aim of study. Assessment of risk factors in the evolution of hepatic disease induced by drug use
Methods and materials. All information was obtained from a literature review based mostly on EASL
Clinical Practice Guidelines.
Results. New epidemiologic data suggest that approximately 20 new cases of DILI per 100,000 persons
occur each year. Idiosyncratic drug induced liver injury accounts for 11% of the cases of acute liver failure
in the United States. According to the research DILI is more likely to occur in females, the elderly, and
patients with chronic liver disease, HIV, and obesity. Female sex may be considered a risk factor for DILI
associated with specific drugs. Age has been cited as a risk factor for DILI, but the at-risk age groups differ
according to specific drugs. Older age is a risk factor for DILI from isoniazid, whereas youth is a risk factor
for DILI related to valproate and aspirin.
Conclusion. Drug induced liver injury is assumed to be a multifactorial condition. Risk factors for DILI
are: medication dose, drug lipophilicity, and extent of hepatic metabolism. There is mixed evidence to
support the role of host factors such as age, sex, and chronic liver disease. The impact of these risk factors
may vary between individuals.
