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Alloveda Liver Update: Alcohol-Related Liver Disease Rarely Detected at Early Stages

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eMediNexus    24 August 2020

There have been several advancements in the treatment of viral hepatitis. Yet, liver-related mortality remains high. This could possibly be attributed to the huge burden of advanced alcohol-related liver disease (ALD).

Shah and colleagues explored if ALD patients are initially seen at later stages of the disease when compared with patients with hepatitis C virus (HCV) infection or other etiologies.

This cross-sectional study included 3453 consecutive patients with either early or advanced liver disease - 1699 with early and 1754 with advanced liver disease - at 17 tertiary care liver or gastrointestinal units across the world, between August 2015 and March 2017. Anthropometric, etiology, and clinical information, as well as model for end-stage liver disease scores were obtained.

The study revealed the following findings:

  • Around 81% patients had one etiology of liver disease; 17% had two etiologies.
  • Among patients seen at early stages for a single etiology, 31% had HCV infection, 21% had hepatitis B virus infection, and 17% had nonalcoholic fatty liver disease, while 3.8% had ALD.
  • About 29% of patients seen for advanced disease had ALD.
  • Patients with ALD had higher odds of being seen at specialized centers, with advanced-stage disease, compared to patients with HCV-associated liver disease (odds ratio, 14.1; 95% CI, 10.5–18.9; P < .001).
  • Among patients with 2 etiologies, excess alcohol use was observed in 50% of cases. These patients had significantly more visits to healthcare providers, with more advanced disease, in comparison with patients without excess alcohol use.

This cross-sectional analysis of patients with liver disease on a global level revealed that patients with ALD are seen with more advanced-stage disease when compared to patients with HCV-associated liver disease. Among patients with two etiologies of liver disease, excess alcohol use was found to be associated with 50% of the cases. Early detection and referral programs are therefore the need of the hour for patients with ALD.

Source: Shah ND, Ventura-Cots M, Abraldes JG, et al.Alcohol-Related Liver Disease Is Rarely Detected at Early Stages Compared With Liver Diseases of Other Etiologies Worldwide.Clinical Gastroenterology and Hepatology 2019;17(11):2320-9.e12.

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