Prevalence, clinical characteristics and risk factors of drug-induced liver injury in hospitalized patients with brucellosis

Abstract

Abstract: Objective To investigate the prevalence, demographic and clinical characteristics and risk factors related to drug-induced liver injury (DILI) in hospitalized patients with brucellosis during treatment. Methods The clinical data of 432 hospitalized patients with brucellosis between June 2019 and June 2024 were selected. Statistics of epidemic information and clinical manifestations of brucellosis; According the occurrence of DILI, the patients were divided into two groups: DILI group and non-DILI group. The clinical data of the two groups were compared and multivariate logistic regression analysis was exerted to explore the independent risk factors of DILI in brucellosis patients. Results Among the 432 cases of brucellosis, the age ranged from 18 to 76 years old, with 50 to 64 years old accounting for 42.1% (182/432). Cases occurred all year round, with summer cases accounting for 44.7% (193/432). 54.4% (235/432) patients were engaged in aquaculture; 72.7% (314/432) had definite animal contact experience. Fever is the most common symptom, accounting for 82.2% (355/432), and the temperature ranges from 37.5℃ to 41.9℃, which is more common in the afternoon and night. Other common clinical manifestations include chills 41.0% (177/432), low back pain 35.2% (152/432), night sweats 21.7% (94/432) and joint pain 17.1% (74/432). The prevalence rate of DILI in brucellosis patients was 14.6% (63/432). There were statistically significant differences in CRP and PCT between patients with and without DILI before and after treatment (P<0.05). Compared with the DILI group before treatment, WBC, CRP, ESR and PCT decreased significantly after treatment (P<0.05). Compared with non-DILI group, ALT, AST and LDL in the DILI group increased significantly before treatment (P<0.05). Compared with the non-DILI group before treatment, ALT, AST and LDL decreased significantly after treatment (P<0.05), but there was no significant difference compared with non-DILI group before treatment (P>0.05). Using DILI occurrence (unincorporated=0, combined=1) in brucellosis patients as the dependent variable, and the indicators of differences between unincorporated and combined DILI as the independent variable, CRP, PCT, ALT, AST and LDL were assigned (measured values) and multivariate logistic regression analysis was conducted. The results showed that CRP, PCT and LDL were independent risk factors for the occurrence of DILI in patients with brucellosis (P<0.05). Conclusion The proportion of patients with brucellosis complicated with DILI is common. CRP, PCT and LDL are important factors to predict the occurrence of DILI in patients with brucellosis.

Key words: Brucellosis, Drug-induced liver injury, Clinical features, Risk factors

CHEN Wen, FAN Jun-wei, ZHAO Peng. Prevalence, clinical characteristics and risk factors of drug-induced liver injury in hospitalized patients with brucellosis[J]. Chinese Hepatolgy, 2025, 30(8): 1129-1132.

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