Alcoholic hepatitis: How far are we and where are we going?

Verónica Prado, Joan Caballería, Víctor Vargas, Ramón Bataller, José Altamirano

Journal: Annals of hepatology 2017;15(4):463-73

PMID: 27236145

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Abstract

The burden of alcoholic liver disease continues to be a major public health problem worldwide. The spectrum of disease ranges from fatty liver to cirrhosis and hepatocellular carcinoma. Alcoholic hepatitis (AH) is a type of acute-on-chronic liver failure and the most severe form of alcoholic liver disease. Severe AH carries a poor short-term prognosis and its management is still challenging, with scarce advances in the last decades. Corticosteroids are still the first line of therapy in severe cases. Unfortunately, many patients do not respond and novel targeted therapies are urgently needed. Liver transplantation has shown extraordinary results in non-responders to corticosteroids however; its applicability is very low. This review summarizes the epidemiology, natural history, risk factors and pathogenesis of alcoholic liver disease with special focus on the latest advances in prognostic stratification and therapy of patients with alcoholic hepatitis.

Address: Intensive Care Unit and Liver Unit. Hospital Clinic; Barcelona, Spain.; Liver Unit. Hospital Clinic. Universidad de Barcelona. Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red en el área temática de enfermedades hepáticas y digestivas (CIBERehd); Barcelona, Spain.; Liver Unit. Internal Medicine Department. Vall d'Hebrón Hospital and Vall d'Hebrón Institut de Recerca (VHIR). Universitat Autónoma de Barcelona; Barcelona, Spain; Centro de Investigación Biomédica en Red en el área temática de enfermedades hepáticas y digestivas (CIBERehd); Barcelona, Spain; Division of Gastroenterology and Hepatology, Department of Medicine; Division of Biochemistry, Department of Nutrition and University of North Carolina, Chapel Hill, NC.; Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina at Chapel Hill, USA.; Liver Unit. Internal Medicine Department. Vall d'Hebrón Hospital and Vall d'Hebrón Institut de Recerca (VHIR). Universitat Autónoma de Barcelona; Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.