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Zika Virus Infectious Cell Culture System and the In Vitro Prophylactic Effect of Interferons
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Presentation and outcomes with clinically apparent interferon beta hepatotoxicity.

Robert J Fontana1, Paul Hayashi, Herbert L Bonkovsky

  • 1Division of Gastroenterology, Department of Internal Medicine, University of Michigan Medical School, University of Michigan Medical Center, 3912 Taubman Center, Ann Arbor, MI 48109-0362, USA. rfontana@med.umich.edu

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Summary

Interferon beta can cause liver injury, primarily in women, with a delayed onset. While most cases of liver damage are self-limiting, some may lead to severe outcomes like liver failure.

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Area of Science:

  • Hepatology
  • Pharmacology
  • Immunology

Background:

  • Hepatotoxicity is a known adverse effect of interferon therapy.
  • Understanding the specific presentation and outcomes of interferon beta-induced liver injury (IBILI) is crucial for patient management.

Observation:

  • Eight patients in the U.S. Drug-Induced Liver Injury Network (DILIN) registry and 11 published cases presented with liver injury attributed to interferon beta.
  • The majority of affected individuals were women, with a mean age of 40-49 years.
  • Injury onset typically occurred after prolonged interferon beta use (median 462 days).

Findings:

  • Patients presented with acute hepatocellular injury, characterized by elevated alanine aminotransferase (ALT) levels.
  • Histological examination revealed centrilobular (zone 3) necrosis with lymphocytic and plasma cell infiltrates.
  • While most patients recovered within 2-3 months, one case resulted in acute liver failure, and others required liver transplantation.

Implications:

  • Interferon beta hepatotoxicity predominantly affects women and can have a delayed onset.
  • The injury pattern, often hepatocellular, suggests an immunologic basis for this adverse drug reaction.
  • Clinicians should be vigilant for liver injury in patients receiving interferon beta, particularly those with prolonged treatment durations.