One of the major organs in the body with multiple functions is the liver. It plays a central role in the transformation of macronutrients and clearance of chemicals and drugs. The serum
biomarkers often used to indicate liver damage are not specifically for
drug-induced liver injury (DILI) or liver injury caused by other
xenobiotics, nor for
viral infection. In this case,
microRNAs (
miRNAs) could play an exciting role as
biomarkers of specific liver damage. In this review, we aimed to update the current literature on liver damage induced by drugs, as acute conditions and
viral infections mediated by the hepatitis B virus (HBV) linked these two conditions to advanced research, with a focus on
microRNAs as early
biomarkers for liver damage. The undoubtable evidence that circulating miR-122 could be used as a human
biomarker of DILI came from several studies in which a strong increase of it was linked with the status of liver function. In infancy, there is the possibility of an early
miRNA detection for
hepatitis B virus infection, but there are a lack of solid models for studying the HVB molecular mechanism of
infection in detail, even if
miRNAs do hold unrealized potential as
biomarkers for early detection of
hepatitis B virus infection mediated by HBV.