519 CELLULAR TH1 AND TH2 IMMUNE RESPONSES TO ALCOHOL DEHYDROGENASE WITHIN THE LIVER OF PATIENTS WITH ALCOHOL-RELATED CIRRHOSIS DESPITE ABSTINENCE

Methods: Reference hepatologists were identified in Argentina, Uruguay, Chile, Brazil, Mexico, Peru, Venezuela and Bolivia, who in turn were commissioned to establish national specialist networks contributing to the project. Data would be obtained using the methodology in place at the Spanish DILI Registry. Identified cases would be remitted to the coordinating centre in Malaga for causality assessment and information storage. Results: Seventy-three DILI cases have been analyzed up to November 2012, having a mean age of 52 years (range 15–86) and female predominance (60%). The therapeutic groups most frequently implicated were NSAIDs (22%) including nimesulide (5 cases) and diclofenac (4 cases); antiinfectives (19%) including nitrofurantoin (3 cases), herbal remedies (12%) including Morinda citrifolia, Peumus boldus and Monascus purpureus; hormonal therapy (12%) including cyproterone acetate (4 cases); and central nervous system drugs (11%). Hepatocellular injury (50%) was the most common type of liver damage. Jaundice was seen in 71% of cases, 53% required hospitalization and 38% fulfilled Hy’s Law criteria (66% of hormonal therapy cases, 44% of herbal cases). Positive autoantibody titers were present in 29% of cases, mainly antinuclear. Six cases were autoimmune hepatitis DILI (8%) and five cases had experienced a second DILI episode (7%). Conclusions: This initial analysis demonstrates similar phenotypic characteristics as observed in registers outside Latin America with respect to type of injury and severity. However, female cases seem to predominate in Latin America. With regards to causative agents, elevated representation of NSAIDs, hormonal treatments and herbal remedies were evidenced. Funding: Agencia Espanola del Medicamento. Proyecto Excelencia SAS P10CTS-6470. iSAEC. CIBERehd is funded by ISCIII.