Drug and herb induced liver injury: Council for International Organizations of Medical Sciences scale for causality assessment

Table 5 Frequency of risk factors of alcohol and age among herb induced liver injury patients

HILI study cohort	Total study cases (n)	Cases scored with risk factors (n)			Total cases scored with risk factors n (%)	Cases with references
		Alcohol	Age	Alcohol + Age
Kava	26	0	6	1	7 (26.9)	Cases 2, 4, 10, 17, 20, 24, 26[12]
Kava	5	0	3	0	3 (60.0)	Cases 1-3[46]
Ayurvedic herbs	1	0	1	0	1 (100.0)	Case 1[30]
Black cohosh	4	2	1	0	3 (75.0)	Cases 2, 3, 4[47]
Black cohosh	9	1	1	0	2 (22.2)	Cases 4, 9[48]
Black cohosh	22	4	2	0	6 (27.3)	Cases 2, 8, 10, 16, 17, 21[36]
Greater Celandine	22	1	9	0	10 (45.5)	Cases 3, 5, 8, 11, 14-18, 21[37]
Greater Celandine	21	0	7	0	7 (33.5)	Cases 4,9, 11, 16-18, 20[32]
Pelargonium sidoides	15	0	3	0	3 (20.0)	Cases 1, 7, 14[38]
Pelargonium sidoides	13	0	7	0	7 (53.9)	Cases 2, 3, 5, 8, 9, 11, 13[39]
Herbalife	8	0	3	0	3 (37.5)	Cases 1, 2, 4[33]
Total	146	8	43	1	52 (35.6)

The study cohort consisted of 146 herb induced liver injury patients patients assessed for the frequency of the risk factors alcohol and age ≥ 55 years. In 52/146 cases (35.6%), risk factors were evident.