Increase Seen in Rates of Xenobiotic-Induced Liver Injury From 2020 to 2024

TUESDAY, Aug. 18, 2026 (HealthDay News) — The rates of xenobiotic-induced liver injury (XILI) have increased, with acetaminophen (APAP) alone being the most frequently implicated xenobiotic, according to a study published online Aug. 13 in Clinical Gastroenterology and Hepatology.

Eleanor Blair Towers, M.D., from the University of Virginia in Charlottesville, and colleagues characterized long-term trends in XILI and APAP- and alcohol-associated liver injury in the United States in a retrospective analysis of the National Poison Data System. Reported xenobiotic exposures involving individuals aged 15 years and older from 2000 to 2024 with biochemical evidence of hepatocellular injury were identified.

The researchers identified 220,160 xenobiotic exposures associated with liver injury. There was a more than fourfold increase in population-adjusted exposure rates (10.9 to 52.9 per million); 54 percent of the exposures were accounted for by women. Inpatient hospitalization was required for more than 80 percent of exposures, indicating substantial clinical severity. Most cases were accounted for by medication-related exposures (men, 85 percent; women, 94 percent); APAP alone was the xenobiotic most frequently implicated (men, 33 percent; women, 45 percent). Following regulatory actions in the early 2010s, there was a decline of about 60 to 85 percent seen in APAP-containing products, whereas a substantial increase was seen in APAP-alone exposures (men, 349 percent; women, 380 percent).

“Liver injuries reported to poison centers have increased substantially over the past 25 years, with acetaminophen emerging as a growing contributor,” lead author Christopher P. Holstege, M.D., also from the University of Virginia, said in a statement. “Our study findings highlight the important role poison centers play in toxico-surveillance.”

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