ArticleJournal of hepatology2018
The role of HLA-A*33:01 in patients with cholestatic hepatitis attributed to terbinafine.
Article in Journal of hepatology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers.
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Who cites it
28 citing papers in PubMed, 47 citations in OpenAlex.
- Terbinafine-induced liver injury with isolated serum alkaline phosphatase elevation: A case report and literature review.The Journal of international medical research · 2026Review
- Human leukocyte antigen pharmacogenetics in infectious diseases: anti-infective drug toxicity and host immune response.Frontiers in pharmacology · 2026Review
- RUCAM-ascertained immunology and autoimmunity specifics of six idiosyncratic drug-induced liver injury types with refined classification: their individual complex molecular interplay.Frontiers in immunology · 2026Review
- Exploring Genetic Clues in Kikuchi-Fujimoto Disease: A Three-Generation Study.Pharmacogenomics and personalized medicine · 2026Article
- DRESS Syndrome in Patients With Drug-Induced Liver Injury: Characteristics and HLA Risk Factors.The American journal of gastroenterology · 2025Article
- Liver Injury due to Intravenous Methylprednisolone in the Drug-Induced Liver Injury Network.Liver international : official journal of the International Association for the Study of the Liver · 2025Article
- Identification of Genetic Risk Factors Associated With Herbal and Dietary Supplement-Induced Acute Liver Failure Using Whole Exome Sequencing Analysis.Gastro hep advances · 2025Article
- Association of HLA-DQA1*06:01 and DPB1*05:01:01G alleles with susceptibility to end-stage liver disease with HBV infection in liver transplant recipients from the Zhejiang Han population, China.Frontiers in immunology · 2025Article
- Genetic and Genomic Approaches to the Study of Drug-Induced Liver Injury.Liver international : official journal of the International Association for the Study of the Liver · 2025Review
- Drug-induced liver injury (DILI) ascribed to non-steroidal anti-inflammatory drugs (NSAIDs) in the USA-Update with genetic correlations.Liver international : official journal of the International Association for the Study of the Liver · 2024Article
- Human Leucocyte Antigen Genetics in Idiosyncratic Drug-Induced Liver Injury with Evidence Based on the Roussel Uclaf Causality Assessment Method.Medicines (Basel, Switzerland) · 2024Review
- Article
- [Genetic susceptibility to drug-induced liver injury].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2023Article
- Clinical features, outcomes, and HLA risk factors associated with nitrofurantoin-induced liver injury.Journal of hepatology · 2023Article
- Liver Damage and microRNAs: An Update.Current issues in molecular biology · 2022Review
- Chronic ocular sequelae in Stevens-Johnson syndrome: a genetic association study.Molecular vision · 2022Article
- Machine Learning to Identify Interaction of Single-Nucleotide Polymorphisms as a Risk Factor for Chronic Drug-Induced Liver Injury.International journal of environmental research and public health · 2021Article
- HLA-associated adverse drug reactions - scoping review.Clinical and translational science · 2021Article
- Progress and Challenges in the Use of a Liver-on-a-Chip for Hepatotropic Infectious Diseases.Micromachines · 2021Review
- HLA-B*35:01 and Green Tea-Induced Liver Injury.Hepatology (Baltimore, Md.) · 2021Article
Corrections and comments
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Authors and funding
11 authors at 8 institutions in 1 country.
Funding
Abstract
BACKGROUND &
aimsTerbinafine is an antifungal agent that has been associated with rare instances of hepatotoxicity. In this study we aimed to describe the presenting features and outcomes of patients with terbinafine hepatotoxicity and to investigate the role of human leukocyte antigen (HLA)-A*33:01.
methodsConsecutive high causality cases of terbinafine hepatotoxicity enrolled into the Drug Induced Liver Injury Network were reviewed. DNA samples underwent high-resolution confirmatory HLA sequencing using the Ilumina MiSeq platform.
resultsAll 15 patients with terbinafine hepatotoxicity were more than 40 years old (median = 57 years), 53% were female and the median latency to onset was 38 days (range 24 to 114 days). At the onset of drug-induced liver injury, 80% were jaundiced, median serum alanine aminotransferase was 448 U/L and alkaline phosphatase was 333 U/L. One individual required liver transplantation for acute liver failure during follow-up, and 7 of the 13 (54%) remaining individuals had ongoing liver injury at 6 months, with 4 demonstrating persistently abnormal liver biochemistries at month 24. High-resolution HLA genotyping confirmed that 10 of the 11 (91%) European ancestry participants were carriers of the HLA-A*33:01, B*14:02, C*08:02 haplotype, which has a carrier frequency of 1.6% in European Ancestry population controls. One African American patient was also an HLA-A*33:01 carrier while 2 East Asian patients were carriers of a similar HLA type: A*33:03. Molecular docking studies indicated that terbinafine may interact with HLA-A*33:01 and A*33:03.
conclusionsPatients with terbinafine hepatotoxicity most commonly present with a mixed or cholestatic liver injury profile and frequently have residual evidence of chronic cholestatic injury. A strong genetic association of HLA-A*33:01 with terbinafine drug-induced liver injury was confirmed amongst Caucasians. LAY SUMMARY: A locus in the human leukocyte antigen gene (HLA-A*33:01, B*14:02, C*08:02) was significantly overrepresented in Caucasian and African American patients with liver injury attributed to the antifungal medication, terbinafine. These data along with the molecular docking studies demonstrate that this genetic polymorphism is a plausible risk factor for developing terbinafine hepatotoxicity and could be used in the future to help doctors make a diagnosis more rapidly and confidently.
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