Hepatitis C, alcohol abuse, and unintentional overdoses are risk factors for acetaminophen-related hepatotoxicity
✍ Scribed by Robert P. Myers; Abdel Aziz M. Shaheen
- Publisher
- John Wiley and Sons
- Year
- 2009
- Tongue
- English
- Weight
- 138 KB
- Volume
- 49
- Category
- Article
- ISSN
- 0270-9139
No coin nor oath required. For personal study only.
✦ Synopsis
Nguyen et al. 1 recently described an increased risk of acute liver injury (ALI) due to acetaminophen overdose (AO) in patients with hepatitis C virus (HCV). ALI occurred in 16.7% and 7.1% of HCV-positive and HCV-negative patients, respectively [odds ratio (OR), 1.64; 95% confidence interval (CI), 1.18-2.26]. Alcoholic and nonalcoholic fatty liver diseases also conferred 5-to 8-fold risks. This commendable study adds to the literature supporting an association between liver disease and acetaminophen-related ALI. [2][3][4] In an analysis of 1543 AO admissions identified with a Canadian database, 4 we reported an increased risk of ALI (OR, 3.50; 95% CI, 1.57-7.77) and mortality (15.2% versus 0.5%; P Ͻ 0.0005) in patients with pre-existing liver disease. Although this study included a small number of HCV patients (n ϭ 10), it provided insight into additional risk factors. Specifically, ALI was more common in patients with unintentional overdoses (OR, 5.18; 95% CI, 3.00-8.95) and alcohol abuse (OR, 2.21; 95% CI, 1.30-3.76). 4 Because patients with liver diseases including HCV are more likely to overdose unintentionally, 4 we wondered whether the increased risk reported by Nguyen et al. could be explained by differences in overdose circumstance. Therefore, we reanalyzed the Nation-