Overview on drug-induced liver injury in Brazil

Abstract

Drug-induced liver injury (DILI) is an uncommon event in clinical practice, which makes knowing its true incidence difficult. Prospective, retrospective and registry-based studies are the most important methods to obtain epidemiological data on DILI. Latin America (LA) has a historical lack of prospective studies on this topic. New definitions and the creation of hepatotoxicity registries have significantly improved the epidemiological understanding of hepatic drug reactions in several regions of the world. The Latin American DILI network, referred to as LATINDILI, has been created in 2011, and recently published its own DILI recommendations describing the most relevant issues on the management of hepatotoxicity in general, and those based on findings from our own LA experience in particular. Although most of the registries do not carry out population-based studies, they may provide important data related to the prevalence of DILI. The joint work among researchers and the corresponding health and regulatory authorities should be stimulated due to the high impact that hepatotoxicity represents for public health.

Keywords: Hepatotoxicity; Drug-induced liver injury; Drug-induced liver injury registries; Herbs; Hepatitis

Core Tip: Liver damage induced by drugs and herbs was historically underreported in Latin America until the advent of a Latin American Registry of Hepatotoxicity (LATINDILI), which progressively improved knowledge about the most frequently involved drugs inducing liver injury in this region. This article letter emphasizes on the value of being able to centralize cases linked to hepatotoxicity in a Latin American drug-induced liver injury network, and discuss the present and future advantages of this valuable tool, which should work along with regulatory entities to achieve a high impact on public health policy.