RE: Incidence and Etiology of Drug-Induced Liver Injury in Mainland China

We read with interest the recent article published in Gastroenterology by Shen et al,1 which reported findings of a retrospective study that determined the incidence and causes of drug-induced liver injury (DILI) in mainland China, and the leading cause of DILI was traditional Chinese medicines (TCM) or herbal and dietary supplements (HDS; 26.81%). Although this is the first large-scale estimate of DILI incidence and etiology in mainland China, there remain several critical issues inevitably making its conclusions to be reconsidered.