Clin Mol Hepatol > Accepted Articles
Subclinical versus advanced forms of alcohol-related liver disease: need for early detection
Concepción Gómez-Medina1 , Luma Melo2 , David Martí-Aguado1 , Ramón Bataller2
1Clinic University Hospital of Valencia. Medical Department. Division of Gastroenterology and Hepatology, Valencia, Spain
2Center for Liver Diseases, Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
Correspondence :  Ramón Bataller ,
Email: BATALLER@pitt.edu
Received: January 18, 2022  Revised: March 6, 2022   Accepted: April 11, 2022
ABSTRACT
Alcohol-related liver disease (ALD) consists of a wide spectrum of clinical manifestations and pathological features, ranging from asymptomatic patients to decompensated cirrhosis and hepatocellular carcinoma. Patients with heavy alcohol intake and advanced fibrosis often develop a subacute form of liver failure called alcohol-induced hepatitis (AH). Globally, most patients with ALD are identified at late stages of the disease, limiting therapeutic interventions. Thus, there is a need for early detection of ALD patients, which is lacking in most countries. The identification of alcohol misuse is hampered by the existence of alcohol underreporting by many patients. There are useful biomarkers that can detect recent alcohol use. Moreover, there are several non-invasive techniques to assess the presence of advanced fibrosis among patients with alcohol misuse, which could identify patients at high risk of liver related events or early death. In this review, we discuss differences between early stages of ALD and AH as the cornerstone of advanced forms. A global overview of epidemiological, anthropometric, clinical, analytical, histological, and molecular differences is summarized in this article. We propose that campaigns aimed at identifying patients with subclinical forms can prevent the development of life-threatening forms.
KeyWords: alcohol-related liver disease, steatohepatitis, alcohol-induced hepatitis

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