Drug-Induced Liver Injury — Or Hepatitis E Virus Infection?

Drug-induced liver injury (DILI) is the leading cause of acute liver failure in the U.S. The diagnosis can be difficult and requires the exclusion of known causes of acute liver injury. Acute hepatitis E virus (HEV) infection is rarely considered in the differential diagnosis of DILI in the Western world because it is believed to occur mainly in developing countries. However, indigenous cases of such infection (often linked to exposure to farm animals) have recently been described in the U.S., and researchers have observed that, in the U.K., up to 12% of cases of acute liver failure initially attributed to DILI were actually caused by acute HEV infection.

To assess the frequency of HEV infection among patients with suspected DILI in the U.S.…