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Importance of Hepatitis C Virus RNA Testing in Patients with Suspected Drug-Induced Liver Injury.

Publication ,  Journal Article
Ahmad, J; Reddy, KR; Tillmann, HL; Hayashi, PH; Chalasani, N; Fontana, RJ; Navarro, VJ; Stolz, A; Barnhart, H; Cloherty, GA; Hoofnagle, JH
Published in: Dig Dis Sci
September 2019

BACKGROUND AND AIMS: The aims were to review the diagnosis, testing and presentation of acute hepatitis C (HCV) in patients initially diagnosed to have drug-induced liver injury (DILI) enrolled in the US DILI Network. METHODS: All patients with suspected DILI underwent testing for competing causes of liver injury and returned for 6-month follow-up. Causality was adjudicated by consensus expert opinion. RESULTS: Between 2004 and 2016, 1518 patients were enrolled and adjudicated and underwent 6 months of follow-up. Initial locally acquired anti-HCV results were available in 1457 (96%), but HCV RNA in only 795 (52%). Stored sera were available for repeat testing, so that results were available on all 1518 patients (1457 for anti-HCV and 1482 for HCV RNA). A total of 104 subjects (6.9%) had evidence of HCV infection-10 positive for HCV RNA alone, 16 for anti-HCV alone and 78 for both. All 104 HCV-positive cases were reviewed, and 23 cases were adjudicated as acute HCV. All presented with acute hepatocellular injury with median ALT 1448 U/L, alkaline phosphatase 232 U/L and total bilirubin 10.8 mg/dL. Twenty-two (96%) patients were jaundiced. While all 23 cases initially had been suspected of having DILI, 19 were adjudicated as acute HCV and not DILI at the 6-month follow-up; while 4 were still considered DILI. CONCLUSIONS: Twenty-three of 1518 (1.5%) cases of suspected DILI were due to acute HCV infection. We recommend that initial and follow-up HCV RNA testing should be performed to exclude HCV in patients with acute hepatocellular injury and suspected DILI.

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Published In

Dig Dis Sci

DOI

EISSN

1573-2568

Publication Date

September 2019

Volume

64

Issue

9

Start / End Page

2645 / 2652

Location

United States

Related Subject Headings

  • Young Adult
  • RNA, Viral
  • Prospective Studies
  • Middle Aged
  • Male
  • Humans
  • Hepatitis C Antibodies
  • Hepatitis C
  • Hepacivirus
  • Gastroenterology & Hepatology
 

Citation

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Ahmad, J., Reddy, K. R., Tillmann, H. L., Hayashi, P. H., Chalasani, N., Fontana, R. J., … Hoofnagle, J. H. (2019). Importance of Hepatitis C Virus RNA Testing in Patients with Suspected Drug-Induced Liver Injury. Dig Dis Sci, 64(9), 2645–2652. https://doi.org/10.1007/s10620-019-05591-w
Ahmad, Jawad, K Rajender Reddy, Hans L. Tillmann, Paul H. Hayashi, Naga Chalasani, Robert J. Fontana, Victor J. Navarro, et al. “Importance of Hepatitis C Virus RNA Testing in Patients with Suspected Drug-Induced Liver Injury.Dig Dis Sci 64, no. 9 (September 2019): 2645–52. https://doi.org/10.1007/s10620-019-05591-w.
Ahmad J, Reddy KR, Tillmann HL, Hayashi PH, Chalasani N, Fontana RJ, et al. Importance of Hepatitis C Virus RNA Testing in Patients with Suspected Drug-Induced Liver Injury. Dig Dis Sci. 2019 Sep;64(9):2645–52.
Ahmad, Jawad, et al. “Importance of Hepatitis C Virus RNA Testing in Patients with Suspected Drug-Induced Liver Injury.Dig Dis Sci, vol. 64, no. 9, Sept. 2019, pp. 2645–52. Pubmed, doi:10.1007/s10620-019-05591-w.
Ahmad J, Reddy KR, Tillmann HL, Hayashi PH, Chalasani N, Fontana RJ, Navarro VJ, Stolz A, Barnhart H, Cloherty GA, Hoofnagle JH. Importance of Hepatitis C Virus RNA Testing in Patients with Suspected Drug-Induced Liver Injury. Dig Dis Sci. 2019 Sep;64(9):2645–2652.
Journal cover image

Published In

Dig Dis Sci

DOI

EISSN

1573-2568

Publication Date

September 2019

Volume

64

Issue

9

Start / End Page

2645 / 2652

Location

United States

Related Subject Headings

  • Young Adult
  • RNA, Viral
  • Prospective Studies
  • Middle Aged
  • Male
  • Humans
  • Hepatitis C Antibodies
  • Hepatitis C
  • Hepacivirus
  • Gastroenterology & Hepatology