Background
Herbal and Dietary Supplements (HDS) are capable of causing liver injury, however, the extent of HDS-induced liver injury compared to western medication (WM)-induced liver injury has not been well studied.
Methods
This was a three-year, retrospective study from 308 centers across Mainland China. 3,877 patients with liver injury due to HDS and 3,796 patients with liver injury due to WM were analyzed. Demographic and clinical characteristics, implicated agents, and severity of liver injury were analyzed using descriptive statistics.
Results
The HDS group was older (average age 47.65 ± 14.8 years) and had more females (57.92%). The latency to onset of liver injury was greater in the HDS group than in the WM group (41 vs. 35 days, P < 0.0001). The median levels of serum aspertate aminotransferase (AST), alanine aminotransferase (ALT), and total bilirubin (TBIL) at injury detection and at peak were significantly higher in the HDS group (P < 0 .0001). The mortality and incidence of acute liver failure (ALF) did not differ significantly between groups (0.59% vs. 0.76%, P = 0.3643; 2.31% vs. 2.13%, P = 0.6253). In patients without pre-existing liver diseases, the frequency of chronic DILI was higher in the HDS group (15.26% vs. 11.13%, P < 0 .0001).
Conclusion
Compared to WM-DILI, HDS-DILI is more common in older individuals and women, and has a longer latency period. HDS seems to cause more severe clinical manifestations, yet it does not increase the risk of fatal clinical outcomes. Further regulations on the use of HDS are needed.