Dakhoul L, et al. - In patients with drug-induced liver injury (DILI), enrolled in the Drug-induced Liver Injury Network (DILIN) prospective study, the link between heavy consumption of alcohol and characteristics and outcomes of DILI were studied. Among heavy consumers of alcohol, anabolic steroids were identified as the most common cause of DILI. In heavy drinkers, DILI was not associated with a greater proportion of liver-related deaths or liver transplantation, relative to non-drinkers.

Methods

• Researchers gathered data from 1198 individuals with definite, highly likely, or probable DILI enrolled in the DILIN study from September 2004 through April 2016.
• Alcohol consumption was inquired in all participants at enrollment and those with any alcohol consumption during previous 12 months were asked to complete the Skinner questionnaire to assess drinking history.
• Heavy consumption of alcohol was defined as more than 3 drinks, on average, per day by men or more than 2 drinks, on average, per day by women.

Results

• Data showed that 348 of the 601 persons who reported consuming at least 1 alcoholic drink in the preceding 12 months, completed the Skinner questionnaire and 80 reported heavy consumption of alcohol.
• Compared with non-drinkers (average age, 49 years), heavy drinkers tended to be younger (average age, 42 years) and a higher proportion were men (63% of heavy drinkers vs 35% of nondrinkers) (P<.01 for each comparison).
• Among heavy drinkers, the most common cause of DILI was anabolic steroids (in 13% vs 2% in non-drinkers) (P<.001).
• Researchers detected significantly higher peak serum levels of alanine aminotransferase (1323 U/L) in heavy drinkers than non-drinkers (754 U/L) (P=.02) and higher levels of bilirubin (16.1 mg/dL vs 12.7 mg/dL in non-drinkers) (P=.03).
• Findings demonstrated no significant difference in liver-related death or liver transplantation between heavy drinkers (occurred in 10%) vs non-drinkers (occurred in 6%) (P=.18).