Human drug hepatotoxicity: a contemporary clinical perspective.
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.


CONCLUSIONS
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.
Assis
David N
DN
Thomas Jefferson University Hospital, Department of Medicine, Suite 805 College, 1025 Walnut Street, Philadelphia, PA 19107, USA.
Navarro
Victor J
VJ
D016907:Adverse Drug Reaction Reporting Systems; D000367:Age Factors; D056486:Chemical and Drug Induced Liver Injury; D002986:Clinical Trials as Topic; D064420:Drug-Related Side Effects and Adverse Reactions; D006801:Humans; D008107:Liver Diseases / Q000175:diagnosis / Q000453:epidemiology; D008111:Liver Function Tests; D019338:Polypharmacy; D012307:Risk Factors; D014481:United States / Q000453:epidemiology