Analysis of clinical characteristics and chronic factors of drug-induced liver injury in chronic hepatitis B infection：A retrospective study

To investigate clinical characteristics and chronic factors of drug-induced liver injury (DILI) among patients with chronic hepatitis B virus (HBV) infection.

DILI patients were enrolled and divided into DILI group and HBV+DILI group. Laboratory indicators were recorded and analyzed. Multivariate logistic regression and receiver operating characteristic (ROC) curve was used to determine risk factors and predictive value for chronic DILI.

Of all 114 patients, 87 in DILI group and 27 in HBV+DILI group. Baseline total bilirubin (TBIL), direct bilirubin (DBIL), and incidence of chronicity were significantly higher in HBV+DILI group than that in DILI group (P = 0.017, P = 0.037, P = 0.045, respectively). While platelet (PLT) and prothrombin activity (PTA) were significantly lower than those in DILI group (P = 0.022, P = 0.013, respectively). HBV infection, baseline aspartate aminotransferase (AST) > 200 U/L and TBIL > 34.2 μmol/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). 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. The sensitivity, specificity, positive predictive value, and negative predictive value of joint diagnosis were 81.0%, 73.1%, 40.5%, and 94.4%, respectively.

HBV infection aggravated liver injury. HBV infection, baseline AST > 200 U/L and TBIL > 34.2 μmol/L were predictors of chronic DILI and the joint diagnosis of them could be used to predict chronic DILI effectively.