Editing Hepatitis (section)

==== Toxic and drug-induced hepatitis ====
Many chemical agents, including medications, industrial toxins, and herbal and dietary supplements, can cause hepatitis.<ref name="Harrison's Principles chapter 361 (Toxic and Drug-Induced)">{{Cite book|title=Harrison's Principles of Internal Medicine 19e|author1=Lee, WM |author2=Dienstag, JL |publisher=McGraw-Hill|year=2015|isbn=978-0-07-180215-4|editor1=Kasper, D |editor2=Fauci, A |editor3=Hauser, S |editor4=Longo, D |editor5=Jameson, J |editor6=Loscalzo, J |chapter=Chapter 361: Toxic and Drug-Induced Hepatitis}}</ref><ref name="Occupational exposure to solvents" /> The spectrum of drug-induced liver injury varies from acute hepatitis to chronic hepatitis to acute liver failure.<ref name="Harrison's Principles chapter 361 (Toxic and Drug-Induced)" /> Toxins and medications can cause liver injury through a variety of mechanisms, including direct [[cell damage]], disruption of cell metabolism, and causing structural changes.<ref>{{cite journal|last=Lee|first=William M.|title=Drug-Induced Hepatotoxicity|journal=New England Journal of Medicine|date=31 July 2003|volume=349|issue=5|pages=474–485|doi=10.1056/NEJMra021844|pmid=12890847}}</ref> Some drugs such as [[paracetamol]] exhibit predictable dose-dependent liver damage while others such as [[isoniazid]] cause idiosyncratic and unpredictable reactions that vary by person.<ref name="Harrison's Principles chapter 361 (Toxic and Drug-Induced)" /> There are wide variations in the mechanisms of liver injury and [[latency period]] from exposure to development of clinical illness.<ref name="Friedman 55e" />

Many types of drugs can cause liver injury, including the [[analgesic]] paracetamol; [[antibiotic]]s such as isoniazid, [[nitrofurantoin]], [[Amoxicillin/clavulanic acid|amoxicillin-clavulanate]], [[erythromycin]], and [[Trimethoprim/sulfamethoxazole|trimethoprim-sulfamethoxazole]]; [[anticonvulsant]]s such as [[valproate]] and [[phenytoin]]; cholesterol-lowering [[statin]]s; [[steroid]]s such as [[Oral contraceptive pill|oral contraceptives]] and [[anabolic steroid]]s; and [[Highly Active Anti-Retroviral Therapy|highly active anti-retroviral therapy]] used in the treatment of [[HIV/AIDS]].<ref name="Friedman 55e" /> Of these, amoxicillin-clavulanate is the most common cause of drug-induced liver injury, and [[paracetamol toxicity]]  the most common cause of acute liver failure in the United States and Europe.<ref name="Harrison's Principles chapter 361 (Toxic and Drug-Induced)" />

[[Herb|Herbal remedies]] and [[dietary supplement]]s are another important cause of hepatitis; these are the most common causes of drug-induced hepatitis in Korea.<ref>{{cite journal|last=Suk|first=Ki Tae|year=2012|title=Drug-induced liver injury: present and future|journal=Clinical and Molecular Hepatology|volume=18|issue=3|pages=249–57|doi=10.3350/cmh.2012.18.3.249|pmc=3467427|pmid=23091804|author2=Kim, Dong Joon}}</ref> The United States–based Drug Induced Liver Injury Network linked more than 16% of cases of hepatotoxicity to herbal and dietary supplements.<ref name="NIH - herbal supplements">{{Cite journal|url=http://livertox.nih.gov/Herbals_and_Dietary_Supplements.htm|title=Herbals_and_Dietary_Supplements|website=livertox.nih.gov|date=2012 |pmid=31643176 |access-date=2016-03-14|url-status=live|archive-url=https://web.archive.org/web/20160508234736/http://livertox.nih.gov/Herbals_and_Dietary_Supplements.htm|archive-date=2016-05-08}}</ref> In the United States, herbal and dietary supplements – unlike [[pharmaceutical drug]]s – are unregulated by the [[Food and Drug Administration]].<ref name="NIH - herbal supplements" /> The [[National Institutes of Health]] maintains the LiverTox database for consumers to track all known prescription and non-prescription compounds associated with liver injury.<ref>{{Cite news|url=https://www.nih.gov/news-events/news-releases/nih-launches-free-database-drugs-associated-liver-injury|title=NIH launches free database of drugs associated with liver injury|date=2015-09-30|work=National Institutes of Health (NIH)|access-date=2018-09-18|language=en}}</ref>

Exposure to other [[hepatotoxin]]s can occur accidentally or intentionally through ingestion, inhalation, and skin absorption. The industrial toxin [[carbon tetrachloride]] and the wild mushroom [[Amanita phalloides]] are other known hepatotoxins.<ref name="Harrison's Principles chapter 361 (Toxic and Drug-Induced)" /><ref name="Occupational exposure to solvents">{{cite journal|last1=Malaguarnera|first1=Giulia|last2=Cataudella|first2=E|last3=Giordano|first3=M|last4=Nunnari|first4=G|last5=Chisari|first5=G|last6=Malaguarnera|first6=M|year=2012|title=Toxic hepatitis in occupational exposure to solvents|journal=World Journal of Gastroenterology|volume=18|issue=22|pages=2756–66|doi=10.3748/wjg.v18.i22.2756|pmc=3374978|pmid=22719183 |doi-access=free }}</ref><ref>{{cite book|chapter-url=http://www.accessmedicine.com/content.aspx?aID=6361074|title=Tintinalli's Emergency Medicine: A Comprehensive Study Guide.|publisher=McGraw-Hill|year=2011|edition=7th|location=New York|chapter=Chapter 83. Hepatic Disorders, Jaundice, and Hepatic Failure|chapter-format=Online|vauthors=O'Mara SR, Gebreyes K|veditors=Cydulka RK, Meckler GD|access-date=26 November 2013|url-status=live|archive-url=https://web.archive.org/web/20131202233459/http://www.accessmedicine.com/content.aspx?aID=6361074|archive-date=2 December 2013}}</ref>