Author/Authors :
Lin, Yanjie Department of Hepatology Division - Peking University Ditan Teaching Hospital, Beijing, China , Xu, Mengjiao Department of Hepatology Division - Beijing Ditan Hospital, Capital Medical University, Beijing, ChinaDepartment of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing, China , Yi, Wei Department of Gynecology and Obstetrics - Beijing Ditan Hospital, Capital Medical University, Beijing, China , Sun, Fangfang Department of Hepatology Division - Beijing Ditan Hospital, Capital Medical University, Beijing, ChinaDepartment of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing, China , Zeng, Zhan Department of Hepatology Division - Peking University Ditan Teaching Hospital, Beijing, China , Bi, Xiaoyue Department of Hepatology Division - Beijing Ditan Hospital, Capital Medical University, Beijing, ChinaDepartment of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing, China , Yang, Liu Department of Hepatology Division - Beijing Ditan Hospital, Capital Medical University, Beijing, ChinaDepartment of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing, China , Zhang, Lu Department of Hepatology Division - Beijing Ditan Hospital, Capital Medical University, Beijing, ChinaDepartment of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing, China , LI, Minghui Department of Hepatology Division - Peking University Ditan Teaching Hospital, Beijing, China , Xie, Yao Department of Hepatology Division - Peking University Ditan Teaching Hospital, Beijing, China
Abstract :
Background: This study investigated clinical characteristics and chronic factors of drug-induced liver injury (DILI) among patients
with chronic hepatitis B virus (HBV) infection.
Methods: DILI patients were enrolled and divided into a DILI group and an HBV+DILI group. Laboratory indicators were recorded
and analyzed. Multivariate logistic regression and the receiver operating characteristic (ROC) curve were used to determine risk
factors and the predictive value for chronic DILI.
Results: Of all the 114 patients, 87 were in the DILI group and 27 were in the HBV+DILI group. Baseline total bilirubin (TBIL), direct
bilirubin (DBIL), and incidence of chronicity were significantly higher in the HBV+DILI group than in the DILI group (P = 0.017, P =
0.037, P = 0.045, respectively). However, platelet (PLT) and prothrombin activity (PTA) were significantly lower in the HBV+DILI group
than in the DILI group (P = 0.022, P = 0.013, respectively). HBV infection, baseline aspartate aminotransferase (AST) > 200 U/L, and
TBIL > 34.2 mol/L were predictors of chronic DILI (OR = 4.481 [95% CI, 1.298 - 15.470], P = 0.018; or = 8.478 [95% CI, 2.079 - 34.566], P =
0.003; or = 7.358 [95% CI, 2.215 - 24.446], P = 0.001). The area under ROC curve (AUC) of joint diagnosis for chronic DILI was 0.814 (95%
CI, 0.704 - 0.925, P < 0.001), which was significantly higher than that of single parameter prediction. Also, the sensitivity, specificity,
positive predictive value, and negative predictive value of joint diagnosis were 81.0%, 73.1%, 40.5%, and 94.4%, respectively.
Conclusions: HBV infection aggravated liver injury. HBV infection, baseline AST > 200 U/L, and TBIL > 34.2 mol/L were predictors
of chronic DILI, and their joint diagnosis could be used to predict chronic DILI effectively.
