Alcohol-related liver disease: Clinical practice guidelines by the Latin American Association for the Study of the Liver (ALEH)

作者：Juan Pablo Arab, Juan Pablo Roblero, José Altamirano, Fernando Bessone, Roberta Chaves Araújo, Fatima Higuera‐de la Tijera, Juan Carlos Restrepo, Aldo Torre, Álvaro Urzúa, Douglas A. Simonetto, Juan G. Abraldeṣ, Nahúm Méndez‐Sánchez, F. Contreras, Michael R. Lucey, Vijay H. Shah, Helena Cortez‐Pinto, Ramón Bataller · 发表于：Annals of Hepatology · 年份：2019 · DOI：10.1016/j.aohep.2019.04.005 · 被引用次数：119 · 研究领域：Alcohol Consumption and Health Effects、Liver Disease Diagnosis and Treatment、Liver Disease and Transplantation

Alcohol-related liver disease (ALD) is a major cause of advanced chronic liver disease in Latin-America, although data on prevalence is limited. Public health policies aimed at reducing the alarming prevalence of alcohol use disorder in Latin-America should be implemented. ALD comprises a clinical-pathological spectrum that ranges from steatosis, steatohepatitis to advanced forms such as alcoholic hepatitis (AH), cirrhosis and hepatocellular carcinoma. Besides genetic factors, the amount of alcohol consumption is the most important risk factor for the development of ALD. Continuous consumption of more than 3 standard drinks per day in men and more than 2 drinks per day in women increases the risk of developing liver disease. The pathogenesis of ALD is only partially understood and recent translational studies have identified novel therapeutic targets. Early forms of ALD are often missed and most clinical attention is focused on AH, which is defined as an abrupt onset of jaundice and liver-related complications. In patients with potential confounding factors, a transjugular biopsy is recommended. The standard therapy for AH (i.e. prednisolone) has not evolved in the last decades yet promising new therapies (i.e. G-CSF, N-acetylcysteine) have been recently proposed. In both patients with early and severe ALD, prolonged abstinence is the most efficient therapeutic measure to decrease long-term morbidity and mortality. A multidisciplinary team including alcohol addiction speciali...