Tuesday, January 22, 2019

Treating alcohol-related liver disease from a public health perspective

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Journal of Hepatology February 2019
Alcohol-related liver disease: Time for action
Ramon Bataller, Gavin E. Arteel, Christophe Moreno, Vijay Shah
The overall landscape of clinical hepatology has markedly evolved in the last few years. Recent major advances in the management of viral hepatitis B and C with highly effective therapies are decreasing the proportion of patients with viral-related end-stage liver disease in many countries.1 Consequently, increasing attention is being paid to fatty liver diseases (both alcohol-related liver disease [ALD] and non-alcoholic fatty liver disease [NAFLD]) as the main current and future driver of liver-related health burdens.

Journal of Hepatology February 2019
Volume 70, Issue 2, Pages 223–236
Treating alcohol-related liver disease from a public health perspective
Theresa Hydes†, William Gilmore†, Nick Sheron, Ian Gilmore

Herein, we describe the evolving landscape of alcohol-related liver disease (ALD) including the current global burden of disease and cost to working-aged people in terms of death and disability, in addition to the larger spectrum of alcohol-related heath complications and its wider impact on society. We further review the most effective and cost-effective public health policies at both a population and individual level. Currently, abstinence is the only effective treatment for ALD, and yet because the majority of ALD remains undetected in the community abstinence is initiated too late to prevent premature death in the majority of cases. We therefore hope that this review will help inform clinicians of the “public health treatment options” for ALD to encourage engagement with policy makers and promote community-based hepatology as a speciality, expanding our patient cohort to allow early detection, and thereby a reduction in the enormous morbidity and mortality associated with this disease.

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