CAM/Drug-Induced Hepatotoxicity: Implications in Viral Hepatitis

In recent times, complementary and alternative medicine (CAM) has gained much popularity in the treatment of various chronic diseases. However, CAM/drug-related heptotoxicity is a serious public health problem where over- or misdiagnosis is a common phenomenon. For example, the initially assumed drug-induced liver injury was actually due to hepatitis E. In clinical practices, casualty assessment of suspected hepatotoxicity is hampered by the lack of a standardized approach that requires simplicity of the methodology. This could be best achieved by the combination of clinical judgment and a liver-specific causality assessment algorithm issued by the Council for International Organizations of Medical Sciences (CIOMS). Therefore, patients with chronic hepatitis should be counseled and screened by physicians on potential risks associated with CAMs and dietary supplementations.