Overview of drug induced liver injury in Brazil: What is the role of public health policy on the evidence?

Table 2 Criteria used for the definition of liver injury

Criteria applied for liver injury definition	Ref.	Condition
Elevated ALT	Tovo et al[47], 2006	HIV/HCV
ALT > 2 × ULN	Monteiro et al[25], 2012	TB
ALT > 2.5 × ULN	Zaverucha-do-Valle et al[41], 2014; Kondo et al[49], 2008	TB/smoker; HIV
ALT > 3 × ULN	Fernandes et al[68], 2015; Santos et al[53] 2013;	TB; TB
ALT or AST > 2 × ULN	Alves et al[59], 2011; de Castro et al[44], 2010	AR; TB/HBV
ALT or AST > 3 × ULN	Heinrich[24], 2014; Vieira et al[78], 2008; Uehara et al[76] 2005	TB/ indigenous; TB; IMQ
ALT or AST > 3 × or BT > 1.5 ×	Schultz et al[46], 2014	TB/TX
ALT > 3 × ULN; BT > 2 ×	Brito et al[64], 2014; Nader et al[45], 2010	TB/HCV
ALT or AST > 3 × ULN; BT > 2 ×	Lima Mde et al[65], 2012; Picon et al[66], 2002	TB/HIV; TB
ALT ≥ 5 × LSN ou FA ≥ 2 × LSN ou ALT ≥ 3 × ULN e BT ≥ 2 × LSN	Prado et al[27], 2019	Gastro-hepatology conditions
(1) ALT > 3 × lower limit of normality; (2) ALT > 3 × ULN; (3) ALT > 3 × ULN and BT > 2 × ULN	Coca et al[73], 2010	TB/HIV
ALT or AST: (1) 1.25 a 2.5 × ULN; (2) 2.6 a 5 × ULN; (3) 5.1 a 10 × ULN; (4) > 10 × ULN	Antonello et al[55], 2014	HIV
ALT or AST: (1) 1.25 a 2.5 × ULN; (2) 2.6 a 5 × ULN; (3) 5.1 a 10 × ULN; (4) > 10 × ULN or BT – (1) 1.1 a 1.5 × ULN; (2) 1.6 a 2.5 × ULN; (3) 2.6 a 5.0 × ULN; (4) > 5.0 × ULN	Tomich et al[77], 2015	TB/HIV
Altered ALT or AST (hepatotoxicity) and ALT or AST > 5 × (hepatitis)	Gusmão Filho et al[43], 2001	TB/children
ALT or AST > 3 × ULN and hepatitis syndromes	Teixeira et al[52], 2011	TB
AST > 3 × ULN and hepatitis syndromes	Szklo et al[67], 2007	TB/previous liver injury
Altered ALT, AST, AP or BT	de Souza et al[79], 1996	TB
Increase in liver function tests	de-Medeiros et al[75], 1998	LMA
Histological assessments	Santos[63], 2013	QT/HPTC
AST or ALT: (1) 1.1-4.9 × ULN; (2) 5.0-9.9 × ULN; (3) 10.0-15.0 × ULN; (4) > 15.0 × ULN	Gil et al[48], 2007	HIV/child/adolescent
ALT > 2 times ULN or the ALT/AP ratio ≥ 5 or AP > 2 times ULN ALT/AP ratio ≤ 2 or ALT > 2 times ULN and ALT/AP ratio between 2 and 5	Magalhães[26], 2015	Several
ALT ou AST > 2 × LSN e BT > 1.3 mg/dL	Santos et al[23], 2019	TB
NI	Silva et al[22], 2019; Carvalho et al[74], 2014; Werner et al[61], 1989	IBD; Ulcerative colitis; Grave’s disease

ALT: Alanine methyltransferase; ULN: Upper limits of normality; AST: Aspartate methyltransferase; BT: Total bilirubin; AP: Alkaline phosphatase; NI: Not identified; TB: Tuberculosis; HIV: Human immunodeficiency virus; HCV: Hepatitis C virus; HBV: Hepatitis B virus; IMQ: Immunosuppressed by chemotherapy; TX: Transplantation; QT: Chemotherapy; HPTC: Hepatectomy; IBD: Inflammatory bowel disease.