Drug-induced liver injury (DILI) is unusual; yet, one of the significant causes of acute liver failure which results in noteworthy morbidity or mortality.

The main etiologic mediators for DILI include anti-epileptics, antibiotics, complementary and alternative medicine (CAM) and non-steroidal anti-inflammatory drugs (NSAIDS).

As tuberculosis remains a very communal infectious disease in these areas, extreme commonly concerned drugs for DILI are anti-tuberculous therapy (ATT).

As per a pilot study in the Department of Gastroenterology in a large tertiary care hospital of western India, patients were enrolled throughout the study period of two years from January 2014 to December 2015. All patients were monitored for at least 6 months or until regularization of liver biochemistry. DILI was considered as prolonged, if serum biochemistry values or imaging endured abnormal at 6 months. Through the 2 year study period, a total of 82 patients, including 41 (50%) women, mean age of 39.5 years (standard deviation [SD], 15.3 years), satisfied the standards for inclusion in the study. The youngest patient was 13 years old and the eldest patient was 76 years old. Whole mortality was 15.85%. Eight out of 13 patients who died, the reason of death was liver associated.

DILI still remnants a challenge in modern day hepatology. Though it is comparatively exceptional cause of liver injury, the overall mortality associated with DILI is noteworthy across all regions of the world.

It was observed that neither older age nor female sex is predisposing factors for DILI.

DILI results in noteworthy overall mortality (15.85%). ATT, anti-epileptic drugs, CAM and antiretroviral drugs are foremost causes of DILI in India. Incidence of jaundice, encephalopathy, MELD score at one week, and alkaline phosphatase at one week are self-determining interpreters of mortality.

Source: Annals of Hepatology: 2017; 16 (3): 442-450