Materiały źródłowe

• #1 Definition, epidemiology and magnitude of alcoholic hepatitis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3124876/

  Alcoholic liver disease (ALD) is a major cause of alcohol-related morbidity and mortality. […] This chapter deals with the epidemiology and magnitude of ALD in general and AH in particular. […] The amount of alcohol consumption that places an individual at risk of developing AH is not known. However, in practice, most patients with AH drink more than 100 g/d, with 150-200 g per day being common. […] Population-based surveys indicate that 68% of adult Americans drink at least one alcoholic beverage per month. […] The rates of development of cirrhosis and mortality are higher in African Americans and Hispanics compared to Caucasians. […] The precise incidence of AH is unknown, although a prevalence of approximately 20% was noted in a cohort of 1604 patients with alcoholism who underwent liver biopsy.

• #1 Definition, epidemiology and magnitude of alcoholic hepatitis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3124876/

  The prevalence of AH may be estimated from the prevalence of alcoholism, which affects 8% of general population in the United States or about 16 million people. […] Heavy drinking and its consequences have a significant impact on public health. […] Excessive alcohol consumption is the third leading preventable cause of death in the United States. […] Trends in mortality from ALD: Age- and sex adjusted incidence rates of ALD-related deaths decreased from 6.9/100 000 persons in 1980 to 4.4/100 000 persons in 2003. […] In summary, AH, a frequent cause of alcohol related morbidity and mortality in patients with chronic alcohol abuse is a common and distinct clinical syndrome.

• #2 Alcohol-associated liver disease: Epidemiology and management | Annals of Hepatology

  https://www.elsevier.es/en-revista-annals-hepatology-16-avance-resumen-alcohol-associated-liver-disease-epidemiology-management-S166526812300265X

  Alcohol is the leading cause of preventable liver morbidity and mortality worldwide, as it is also the most frequent cause of advanced liver disease. […] Alcohol-associated liver disease (ALD) covers different phenotypes ranging from steatosis to the development of inflammation (steatohepatitis), fibrosis and ultimately, in a proportion of patients, the development of liver cirrhosis and its associated complications. […] Hazardous alcohol consumption caused in 2018 roughly 3 million deaths globally (5.3 % of all deaths) according to the World Health Organization (WHO). […] Alcohol is the seventh leading risk factor for both premature deaths and disabilities worldwide. […] There are geographical differences regarding alcohol-associated morbidity and mortality; the WHO European Region being the most affected area.

• #2 Alcohol-associated liver disease: Epidemiology and management | Annals of Hepatology

  https://www.elsevier.es/en-revista-annals-hepatology-16-avance-resumen-alcohol-associated-liver-disease-epidemiology-management-S166526812300265X

  The prevalence is not well known, because of disparities in AH diagnosis, but it is believed to occur in 10-35 % of patients with advanced fibrosis and heavy alcohol intake. […] The risk of developing cirrhosis in the setting of AUD is related to host susceptibility, including genetic and environmental factors. […] A special mention should be made when assessing the interaction between alcohol consumption and metabolic risk factors as cofactors for liver disease. […] Alcohol-associated hepatitis (AH) is a severe clinical presentation of ALD, which is characterized by abrupt jaundice and clinical decompensations of liver disease. […] Currently, there are no approved targeted therapies able to interfere in the pathogenesis of ALD and halt the progression of the disease, therefore alcohol abstinence is the most effective measure to improve prognosis in this patient population.

• #3 Alcohol-associated liver disease: Epidemiology and management | Annals of Hepatology

  https://www.elsevier.es/en-revista-annals-hepatology-16-articulo-alcohol-associated-liver-disease-epidemiology-management-S166526812300265X

  Alcohol-associated hepatitis (AH) is an acute deterioration that occurs in people with underlying ALD, and mostly in the presence of cirrhosis. […] The prevalence is not well known, because of disparities in AH diagnosis, but it is believed to occur in 10-35 % of patients with advanced fibrosis and heavy alcohol intake. […] The risk of developing cirrhosis in the setting of AUD is related to host susceptibility, including genetic and environmental factors. […] A special mention should be made when assessing the interaction between alcohol consumption and metabolic risk factors as cofactors for liver disease. […] In the last years, AH has emerged as a new indication of early liver transplantation in non-responders to medical therapy, with promising results in highly selected patients.

• #3 Alcohol-associated liver disease: Epidemiology and management | Annals of Hepatology

  https://www.elsevier.es/en-revista-annals-hepatology-16-articulo-alcohol-associated-liver-disease-epidemiology-management-S166526812300265X

  Alcohol is the leading cause of preventable liver morbidity and mortality worldwide, as it is also the most frequent cause of advanced liver disease. […] Alcohol-associated liver disease (ALD) covers different phenotypes ranging from steatosis to the development of inflammation (steatohepatitis), fibrosis and ultimately, in a proportion of patients, the development of liver cirrhosis and its associated complications. […] Hazardous alcohol consumption caused in 2018 roughly 3 million deaths globally (5.3 % of all deaths) according to the World Health Organization (WHO). […] Alcohol is the seventh leading risk factor for both premature deaths and disabilities worldwide. […] There are geographical differences regarding alcohol-associated morbidity and mortality; the WHO European Region being the most affected area.

• #3 Alcohol-associated liver disease: Epidemiology and management | Annals of Hepatology

  https://www.elsevier.es/en-revista-annals-hepatology-16-articulo-alcohol-associated-liver-disease-epidemiology-management-S166526812300265X

  Alcohol-associated liver disease (ALD) encompasses a broad spectrum of liver injuries that can eventually lead to cirrhosis, being the most frequent cause of cirrhosis worldwide. […] Both ALD and AUD have a significant impact on countries economies. […] Alcohol consumption also has detrimental effects on chronic liver disease due to other etiologies; therefore, abstinence should be the mainstay for all patients with liver disease since no safe threshold exists. […] The frequency and amount of alcohol use are the two main driving factors of disease progression. […] The amount above which alcohol may start increasing morbidity and mortality has been explored in epidemiological studies. […] Harmful alcohol consumption is defined as a daily intake of more than 2 standard drinks in men and 1 standard drink in women, or the presence of binge drinking.

• #4 The Mexican consensus on alcoholic hepatitis | Revista de Gastroenterología de México

  https://www.revistagastroenterologiamexico.org/en-the-mexican-consensus-on-alcoholic-articulo-S2255534X20300542

  Alcohol consumption patterns are defined as: a) hazardous drinking, more than three standard drinks per day for men (30g/day) and more than two standard drinks per day for women (20g/day); b) heavy episodic drinking, six or more standard drinks (60g of alcohol on at least one occasion); and c) binge drinking, four or more standard drinks for women (40g of alcohol) and five or more standard drinks for men (50g of alcohol) in fewer than two hours. […] Alcoholic hepatitis is a severe condition that frequently behaves as acute-on-chronic liver failure. It is characterized by systemic inflammation and a predisposition to the development of infections, kidney failure, encephalopathy, and multiple organ dysfunction, with an elevated mortality rate of 20-50% in the following three months, albeit possibly higher in the Mexican population.

• #5 Alcoholic Hepatitis (Alcohol-Associated Hepatitis): Background, Etiology and Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/170539-overview

  The prevalence of alcohol-related liver disease is high, with a rising rate of worsening mortality. Alcohol abuse is the most common cause of serious liver disease in Western societies, causing 80% of hepatotoxic deaths and 50% of liver cirrhosis. In the United States alone, alcoholic liver disease affects more than 2 million people (ie, approximately 1% of the population). The true prevalence of alcoholic hepatitis, especially of its milder forms, is unknown, because patients may be asymptomatic and may never seek medical attention. […] Globally, the prevalence of alcoholic hepatitis appears to differ widely among different countries. In the Western hemisphere, when liver biopsies were performed in people who drank moderate to heavy amounts of alcohol and were asymptomatic, the prevalence of alcoholic hepatitis was found to be approximately 25-30%.

• #5 Alcoholic Hepatitis (Alcohol-Associated Hepatitis): Background, Etiology and Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/170539-overview

  The estimated minimum daily ethanol intake required for the development of cirrhosis is 40 g for men and 20 g for women, older than 15-20 years. Furthermore, for patients who continue to drink after a diagnosis of alcoholic liver disease, the 5-year survival rate is approximately 30% for women compared with 70% for men. […] To date, no single factor can account for this increased female susceptibility to alcoholic liver damage. Lower gastric mucosal alcohol dehydrogenase (ADH) content in women has been suggested to possibly lead to less first-pass clearance of alcohol in the stomach. A higher prevalence of autoantibodies has been found in the sera of females with alcoholism compared with males with alcoholism, but their clinical significance is questionable. Perhaps hormonal influences on the metabolism of alcohol or the higher prevalence of immunologic abnormalities is responsible for the differences described in the prevalence of alcoholic liver damage between men and women.

• #5 Alcoholic Hepatitis (Alcohol-Associated Hepatitis): Background, Etiology and Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/170539-overview

  Although no genetic predilection is noted for any particular race, alcoholism and alcoholic liver disease are more common in minority groups, particularly among Native Americans. Likewise, since the 1960s, death rates from alcoholic hepatitis and cirrhosis have consistently been far greater for the non-White population than the White population. The non-White male rate of alcoholic hepatitis is 1.7 times the White male rate, 1.9 times the non-White female rate, and almost four times the White female rate. […] Alcoholic hepatitis can develop at any age. However, its prevalence parallels the prevalence of ethanol abuse in the population, with a peak incidence in individuals aged 20-60 years. […] Women are more susceptible than men to the adverse effects of alcohol. Women develop alcoholic hepatitis after a shorter period and smaller amounts of alcohol abuse than men, and alcoholic hepatitis progresses more rapidly in women than in men.

• #6 Epidemiology of Alcohol-associated Liver Disease

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8996817/

  Although alcoholic steatosis is common among excessive drinkers, its prevalence in the general population is difficult to determine because most patients are asymptomatic and do not seek any medical attention. The estimated prevalence also depends on the diagnostic modalities being used to screen for steatosis. […] The precise incidence and prevalence of AH are difficult to estimate because patients with AH may be completely asymptomatic and undiagnosed clinically. […] In a nationwide population-based estimate of AH incidence in Denmark between 1999 and 2008, the annual incidence increased from 37 million to 46 million in men and 24 million to 34 million in women, with a significant increase among middle-aged women. […] The authors reported an increase in total cases of AH-related hospitalization from 249,884 (0.66% of total admission in 2002) to 326,403 (0.83% of total admission in 2010) in the United States.

• #6 Epidemiology of Alcohol-associated Liver Disease

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8996817/

  AH poses a significant financial burden in the health care system because of the high readmission rate, ranging from 20% to 25% at 30 days and around 37% at 90 days after discharge. […] The annualized rate of progression of AH to cirrhosis is around 10%, with annualized mortality from 5% to 15%. […] The global, regional, and national burden of cirrhosis by cause in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. […] The overall prevalence of ALD in the US population is stable around 0.8% to 1% from 1988 to 2016. […] The number of hospitalizations among patients with alcoholic cirrhosis per 1000 increased by 32.8%, with the annualized mortality around 8%. […] Increased death rates in this age group are driven primarily by alcoholic cirrhosis, with an average annual percentage change of 10.5% from 2009 to 2016.

• #7

  https://journals.lww.com/hep/fulltext/2024/12000/alcohol_associated_liver_disease_global.4.aspx

  The accurate estimation of the impact of ALD is complicated by factors such as underreporting, diagnostic difficulties, inconsistent data quality across health registries, and interactions of alcohol with other risk factors for liver disease. […] The COVID-19 pandemic exacerbated the trend of increasing ALD incidence, as high-risk drinking patterns coincided with more hospital admissions for alcohol-associated hepatitis and a rise in ALD-related mortality. […] ALD is increasingly prevalent among younger adults and is now the leading indication for liver transplantations in United States and Europe. […] A robust response to ALD requires public health initiatives, better diagnostic techniques, and comprehensive studies to understand and mitigate its rising impact.

• #7

  https://journals.lww.com/hep/fulltext/2024/12000/alcohol_associated_liver_disease_global.4.aspx

  Alcohol-associated liver disease (ALD), as highlighted in this narrative review, is a major public health concern, increasingly impacting global disease burden and premature mortality. In 2019, ALD accounted for the loss of 11 million life-years worldwide. The rising number of deaths and disability-adjusted life-years attributed to ALD, particularly pronounced in the United States, are alarming. Projections suggest that the economic impact of ALD, as seen in the United States, could potentially double by 2040. ALD is increasingly prevalent among younger adults (20-45 y) and has become the leading cause of liver transplantation in both United States and Europe. […] During the COVID-19 pandemic, the existing trend was further amplified as high-risk drinking patterns coincided with a rise in hospital admissions for alcohol-associated hepatitis and increased ALD-related mortality. The prevalence of ALD is estimated at 3.5% in the general population, 26.0% among hazardous drinkers, and 55.1% among those with alcohol use disorders. Alarmingly, 5-year mortality rates for patients with ALD exceed 50%, with even higher rates in more advanced disease stages.

• #8 Definition, epidemiology and magnitude of alcoholic hepatitis

  https://www.wjgnet.com/1948-5182/full/v3/i5/108.htm

  The precise incidence of AH is unknown, although a prevalence of approximately 20% was noted in a cohort of 1604 patients with alcoholism who underwent liver biopsy. […] The true prevalence of AH is difficult to assess because AH may be completely asymptomatic and often remains undiagnosed. […] Heavy drinking and its consequences have a significant impact on public health. […] In 1990, alcohol accounted for 3.5% of the global burden of disease, whereas tobacco accounted for 2.6%. […] ALD is the second most common indication for orthotopic liver transplantation (OLT) for chronic liver disease in the Western world. […] This makes ALD the second most frequent indication (after hepatitis C) for OLT. […] Excessive alcohol consumption is the third leading preventable cause of death in the United States. […] Although there are various causes of death among alcoholics, liver disease stands out as a significant cause of mortality. […] In summary, AH, a frequent cause of alcohol related morbidity and mortality in patients with chronic alcohol abuse is a common and distinct clinical syndrome.

• #8 Definition, epidemiology and magnitude of alcoholic hepatitis

  https://www.wjgnet.com/1948-5182/full/v3/i5/108.htm

  Definition, epidemiology and magnitude of alcoholic hepatitis. Alcoholic liver disease (ALD) is a major cause of alcohol-related morbidity and mortality. […] This chapter deals with the epidemiology and magnitude of ALD in general and AH in particular. […] The amount of alcohol consumption that places an individual at risk of developing AH is not known. However, in practice, most patients with AH drink more than 100 g/d, with 150-200 g per day being common. […] Patterns of alcohol intake around the world are constantly evolving and have a strong bearing on the prevalence and incidence of ALD. […] Population-based surveys indicate that 68% of adult Americans drink at least one alcoholic beverage per month. […] Heavy alcohol consumption is generally more common in people with low educational level and income, the unemployed, and in those with occupations that are characterized by job alienation, job stress, and low job satisfaction.

• #9 Alcoholic hepatitis – Wikipedia

  https://en.wikipedia.org/wiki/Alcoholic_hepatitis

  Alcoholic hepatitis occurs in approximately 1/3 of chronic alcohol drinkers. […] 10-20% of patients with alcoholic hepatitis progress to alcoholic liver cirrhosis every year. […] Patients with liver cirrhosis develop liver cancer at a rate of 1.5% per year. […] In total, 70% of those with alcoholic hepatitis will go on to develop alcoholic liver cirrhosis in their lifetimes. […] Infection risk is elevated in patients with alcoholic hepatitis (12-26%). It increases even higher with use of corticosteroids (50%) when compared with the general population. […] Untreated alcoholic hepatitis mortality in one month of presentation may be as high as 40-50%.

• #10 Alcoholic Hepatitis

  https://mobile.fpnotebook.com/GI/Lvr/AlchlcHpts.htm

  Alcoholic Hepatitis seen in 33% of chronic Alcoholics. […] Accounted for 0.8% of hospital admissions in U.S., 2010. […] High Incidence of comorbid acute infection in Alcoholic Hepatitis. […] Severe Alcoholic Hepatitis mortality 16 to 30% at 28 days (56% at one year). […] Cirrhosis develops in 50% of chronic Alcoholic Hepatitis patients.

• #11 Pulsenotes | Alcoholic hepatitis notes

  https://app.pulsenotes.com/medicine/hepatology/notes/alcoholic-hepatitis

  Alcohol accounts for the majority of liver disease within the UK. […] ArLD is a major public health problem. Rising numbers of people are dying from liver disease associated with alcohol, particularly in young age groups. Mortality from ArLD is estimated at 9.0 per 100,000 people under 75 years old. […] The true prevalence of alcoholic hepatitis is difficult to quantify as many milder cases may go unnoticed. Severe alcoholic hepatitis is associated with a high morbidity and mortality. In those who develop severe alcoholic hepatitis and survive, relapse is estimated at 25% after one year.

• #12 Alcoholic Hepatitis: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0400/p412.html

  The incidence of alcoholic hepatitis is difficult to estimate because of inconsistency in diagnosis of the disease and overlap with concurrent, more easily diagnosed liver diseases, such as hepatitis C. However, hospital admissions for alcoholic hepatitis are on the rise in the United States, accounting for 0.83% of all admissions in 2010. Risk factors for the development of the disease include prolonged and heavy alcohol use, younger age, female sex, genetic susceptibility, higher body mass index, and comorbid liver disease. Overall and in-hospital mortality are high for severe alcoholic hepatitis, with a 28-day mortality rate of 16% to 30% and a one-year mortality rate of 56%. The presence of underlying cirrhosis and continued alcohol use negatively impact long-term prognosis. […] The disease is most commonly associated with spontaneous bacterial peritonitis, urinary tract infection, pneumonia, enterocolitis, and cellulitis.

• #13 Recent advances in alcoholic hepatitis | F1000Research

  https://f1000research.com/articles/9-97

  The epidemiology of AH is poorly understood, particularly in the US, where liver biopsy is rarely performed for this condition. Trends in patterns of alcohol use, however, suggest that AH incidence rates are likely to increase in Western nations. […] With the changing epidemiology of alcohol use and alcohol-related liver disease, the health-care and economic burden of AH has increased over the last decade. For example, an analysis of the Nationwide Inpatient Sample demonstrated increased rates of hospitalization for AH from 2002 to 2010. […] Although a significant proportion of these deaths are likely attributable to AH, no US studies have systematically explored the epidemiology of AH. In a Danish national cohort study, the incidence of AH rose from 24 to 34 per million women and from 37 to 46 per million men between 1999 and 2008, and it is likely that similar trends have occurred in other Western nations.

• #14 Alcohol-Associated Hepatitis Rapidly Increasing in the US

  https://www.hcplive.com/view/alcohol-associated-hepatitis-rapidly-increasing-us

  Rates of alcohol-associated hepatitis increased by more than 73% among patients with lower socioeconomic status in just 4 years since 2015, according to new research. […] According to new data from a team of Mayo Clinic investigators, alcohol-associated hepatitis is on a rapid increase in the US particularly among women and persons who live on a lower income. […] The incidence of alcohol-associated hepatitis is increasing rapidly, especially among females and individuals of lower socioeconomic status, investigators concluded.

• #15 Global prevalence, incidence, and outcomes of alcohol related liver diseases: a systematic review and meta-analysis | BMC Public Health | Full Text

  https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-023-15749-x

  The prevalence of ARLD was higher in most European countries. […] The prevalence of ARLD in India (11.8%) and Japan (10.4%) was high. […] The prevalence of ARLD was higher in males (2.9%) than in females (0.5%). […] The incidence in males was about four times as high as that in females (0.163 vs. 0.035 per 1000 person-years).

• #15 Global prevalence, incidence, and outcomes of alcohol related liver diseases: a systematic review and meta-analysis | BMC Public Health | Full Text

  https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-023-15749-x

  The prevalence of ARLD worldwide was 4.8%. The prevalence in males was 2.9%, which was higher than female (0.5%). Among the ethnic groups, the percentage was highest in Caucasians (68.9%). […] The incidence was 0.208/1000 person-years. The overall mortality was 23.9%, and the liver-related mortality was 21.6%. […] The global prevalence of ARLD was 4.8% and was affected by sex, region, drinking years, and other factors. […] Understanding the epidemiology of ARLD is essential to formulate the relevant prevention and control policies. […] The prevalence of alcoholic liver cirrhosis in cirrhosis population was increased by 43% in 7 years in the USA. […] The number of deaths from ARLD in South Korea increased from 1403 to 3588 between 2000 and 2009. […] The prevalence of ARLD was 3.9% in Chinese people, which was lower than the global prevalence.

• #16

  https://www.xiahepublishing.com/2310-8819/JCTH-2024-00034

  Alcoholic liver disease (ALD) encompasses liver damage caused by chronic, excessive alcohol consumption. […] With China’s rapid economic growth, coupled with a complex social background and the influence of a deleterious wine culture, the number of patients with ALD in China has increased significantly; the disease has become a social and health problem that cannot be ignored. […] ALD is caused by chronic alcohol consumption and is among the most common causes of liver-related morbidity and mortality. Its incidence is increasing worldwide, placing heavy burdens on healthcare systems. […] The global incidence of alcohol-related hepatitis has increased in recent years, especially among young people and women. […] The prevalence of ALD in China (4.5%) is now comparable to that in the United States (6.2%) and European countries (6%), and higher than that in Japan (1.5-2.3%). […] The status of ALD in China is thus serious and requires increased attention. […] The irrational consumption of alcohol contributes not only to the growing burden of ALD and the increased need for medical care, but also to a societal burden.

• #17

  https://xiahepublishing.com/2310-8819/JCTH-2024-00034

  Alcoholic liver disease (ALD) encompasses liver damage caused by chronic, excessive alcohol consumption. […] With China’s rapid economic growth, coupled with a complex social background and the influence of a deleterious wine culture, the number of patients with ALD in China has increased significantly; the disease has become a social and health problem that cannot be ignored. […] ALD is caused by chronic alcohol consumption and is among the most common causes of liver-related morbidity and mortality. Its incidence is increasing worldwide, placing heavy burdens on healthcare systems. […] The number of people with ALD in China has increased considerably (currently exceeding 62 million), and ALD has become a public health problem that cannot be ignored. […] The global incidence of alcohol-related hepatitis has increased in recent years, especially among young people and women.

• #18 Alcohol-related hepatitis: A review article

  https://www.wjgnet.com/1007-9327/full/v29/i17/2551.htm

  There are significant differences based on gender. Women are at a higher risk of developing ARH at a lower threshold compared to men. […] There has been an increase in the cases of ARH in women in recent years. […] Mortality has been estimated to be around 15% at 30 d and 39% at 1 year and has been linked to the severity of the disease. […] The pattern of drinking as well as the type of alcohol consumed also contributes to the risk of developing ARH. […] Studies have shown a 53% increase in ARH from 2019 to 2020 with a 64% increase in the latter phase of the pandemic. […] The amount of alcohol consumption that places patients at risk of ARH is largely unknown. […] The majority of patients with ARH consume more than 100 g/d of alcohol. […] The increase was noted in the mean inpatient cost for ARH hospitalizations from $31189 in 2009 to $62229 in 2019.

• #18 Alcohol-related hepatitis: A review article

  https://www.wjgnet.com/1007-9327/full/v29/i17/2551.htm

  The combination of alcohol misuse and chronic hepatitis C (HCV) increases the incidence of cirrhosis and hepatocellular carcinoma (HCC) and is associated with reduced survival compared to patients with either HCV or alcohol use alone. […] While the literature clearly demonstrated worse outcomes in patients with concomitant alcohol misuse and chronic HCV, the data regarding the effect of alcohol use on patients with chronic hepatitis B (HBV) remains understudied. […] The COVID-19 pandemic exacerbated the pre-existing trend of rising cases of ARH.

• #19 Alcoholic Hepatitis

  https://cmefix.emcrit.org/ibcc/alcoholic-hepatitis/

  Alcoholic hepatitis occurs following chronic alcoholism (e.g., 5 years), but it can occur after shorter periods of intense exposure (e.g., 6 months). Patients may stop drinking days or weeks prior to admission, because they feel too ill to drink. […] Steady alcohol intake is more likely to cause alcoholic hepatitis than binge drinking. Hepatitis can result from daily consumption of ~40 grams alcohol in women or ~60 grams of alcohol in men (e.g., only three drinks per day among women). […] The relationship between alcohol intake and alcoholic hepatitis is complex. Numerous factors, including sex, genetics, and nutritional status, may affect the risk of alcoholic hepatitis. […] Epidemiology, signs, symptoms, and lab abnormalities are extremely similar between alcoholic cirrhosis and alcoholic hepatitis. […] Alcoholic hepatitis and alcoholic cirrhosis overlap to a large extent (e.g., the presence of cirrhosis doesn’t exclude alcoholic hepatitis).

• #20 Alcoholic Liver Disease | Cleveland Clinic

  https://my.clevelandclinic.org/departments/digestive/medical-professionals/hepatology/alcoholic-liver-disease

  Ethnicity and genetics are important factors related to ALD. […] In general, the risk of liver disease increases with the quantity and duration of alcohol intake. […] Although alcohol use is necessary for ALD, excessive alcohol use does not necessarily promote ALD. […] There is a clear dose-dependent relation between alcohol intake and the incidence of alcoholic cirrhosis. […] A daily intake of more than 60 g of alcohol in men and 20 g of alcohol in women significantly increases the risk of cirrhosis. […] The diagnosis of alcoholic hepatitis is also based on a thorough history, physical examination, and review of laboratory tests. […] A recent consensus statement from the Alcoholic Hepatitis Consortium provided a working definition of alcoholic hepatitis that includes jaundice within 60 days of heavy consumption (50 g/day) of alcohol for a minimum of 6 months.

• #21 AMONG YOUNG ADULTS SURVIVING A FIRST PRESENTATION OF ACUTE ALCOHOLIC HEPATITIS, FEMALES ARE AT 50% HIGHER RISK OF PROGRESSION TO CIRRHOSIS AND DECOMPENSATION | AASLD

  https://www.aasld.org/the-liver-meeting/among-young-adults-surviving-first-presentation-acute-alcoholic-hepatitis-females

  AMONG YOUNG ADULTS SURVIVING A FIRST PRESENTATION OF ACUTE ALCOHOLIC HEPATITIS, FEMALES ARE AT 50% HIGHER RISK OF PROGRESSION TO CIRRHOSIS AND DECOMPENSATION […] Alcohol related harms to adolescents and young adults (AYAs) are on the rise and a priority group for identification and treatment to prevent progression of alcohol-associated liver disease (ALD). […] This study aimed to evaluate the association between female sex and incident cirrhosis after first presentation of AH in the general population. […] After adjusted competing risks regression, female sex was associated with a 47% higher subhazard of cirrhosis compared to male sex (sHR 1.47, 95% CI 1.23-1.76, P .001) in addition to older age (sHR 1.05, 95% CI 1.03-1.06) and higher co-morbidity (sHR 1.36, 95% CI 1.01-1.82; Table). […] Almost 1/3rd of young adults with first presentation of AH develop cirrhosis after a median of 4 years and this risk is 50% higher for females vs. males.

• #22 Alcoholic liver disease epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Alcoholic_liver_disease_epidemiology_and_demographics

  Alcoholic hepatitis commonly affects individuals between 40 and 50 years. […] Alcoholic liver disease usually progresses faster in individuals of the hispanic ethnicity. […] Women are at a higher risk to be affected by alcoholic liver disease than men. […] Alcohol abuse is responsible for five percent (100,000 per year in 1996) of deaths occurring annually in the United States. […] In western countries alcoholic liver disease is the second most common indication for liver transplantation in patients with chronic liver disease.

• #23 Epidemiology and outcomes of alcohol-associated hepatitis in adolescents and young adults – Childrens Liver Disease Foundation

  https://childliverdisease.org/epidemiology-and-outcomes-of-alcohol-associated-hepatitis-in-adolescents-and-young-adults/

  Importance: Alcohol-associated hepatitis (AH) has high mortality, and rates are increasing among adolescents and young adults (AYAs). […] A total of 3340 AYAs with AH were identified. […] Rates of AH increased by 8% per year (RR, 1.08; 95% CI, 1.07-1.09), with yearly rates increasing faster among females (RR, 1.11; 95% CI, 1.09-1.12) than males (RR, 1.07; 95% CI, 1.06-1.07). […] Over the past 2 decades, the rates of AH among AYAs increased significantly, with the greatest increase observed among females.

• #24 Global epidemiology of alcohol-associated cirrhosis and HCC: trends, projections and risk factors | Nature Reviews Gastroenterology & Hepatology

  https://www.nature.com/articles/s41575-022-00688-6

  Heavy alcohol consumption is a major cause of morbidity and mortality. […] In 2019, an estimated 25% of global cirrhosis deaths were associated with alcohol. […] The global estimated age-standardized death rate (ASDR) of alcohol-associated cirrhosis was 4.5 per 100,000 population, with the highest and lowest ASDR in Africa and the Western Pacific, respectively. […] The annual incidence of hepatocellular carcinoma (HCC) among patients with alcohol-associated cirrhosis ranged from 0.9% to 5.6%. […] Alcohol was associated with approximately one-fifth of global HCC-related deaths in 2019. […] Between 2012 and 2017, the global estimated ASDR for alcohol-associated cirrhosis declined, but the ASDR for alcohol-associated liver cancer increased. […] Measures are required to curb heavy alcohol consumption to reduce the burden of alcohol-associated cirrhosis and HCC. […] The risk factors for the development of cirrhosis and HCC include the amount of alcohol consumed, age, obesity, diabetes, smoking and PNPLA3 variants.

• #25 Alcohol-Related Liver Disease – Hepatic and Biliary Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/hepatic-and-biliary-disorders/alcohol-related-liver-disease/alcohol-related-liver-disease

  Alcohol consumption is high in most Western countries. According to a survey using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) definition of alcohol use disorder, in 2021, 11.3% of US adults age 18 and older had alcohol use disorder in the past year. The NIAAA reported a 25.5% increase in deaths involving alcohol use, from approximately 79,000 to more than 99,000 per year from 2019 to 2020, up from the 2.2% increase per year over the previous two decades, suggesting an increase due to the COVID-19 pandemic. […] Disorders of the liver that occur in people with alcohol use disorder, often in sequence, but sometimes coexisting, include Alcoholic hepatitis (in 10 to 35%). […] The American Association for the Study of Liver Diseases (AASLD) recommends that patients receiving care in primary care and gastroenterology/hepatology outpatient clinics, emergency departments, and in hospitals (as inpatients) be screened routinely for alcohol use with validated questionnaires.

• #25 Alcohol-Related Liver Disease – Hepatic and Biliary Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/hepatic-and-biliary-disorders/alcohol-related-liver-disease/alcohol-related-liver-disease

  The AASLD recommends using the Alcohol Use Disorders Inventory Test (AUDIT) if excessive alcohol use is suspected. […] The American Association for the Study of Liver Diseases (AASLD) recommends that liver ultrasonography, with or without alpha-fetoprotein (AFP) measurement, should be done every 6 months to screen for hepatocellular carcinoma. They also suggest that surveillance not be done for patients with Childs class C cirrhosis unless they are on the transplant waiting list because of their low anticipated survival. […] During the COVID-19 pandemic, transplant waitlist registrants increased more than 50% from pre-COVID predictions, possibly due to the increase in alcohol use disorder as well as changes in transplant center risk stratification.

• #26 Alcoholic Liver Disease (ALD) – Oxford Medical Education

  https://oxfordmedicaleducation.com/gastroenterology/alcoholic-liver-disease-ald/

  Common difficult to say exactly how much as many cases dont present or are asymptomatic […] About 20% of alcoholics will get cirrhosis […] Risk factors: Continuous high alcohol intake […] Binge drinking (although occasional binges better than drinking a lot every day) […] Genetic predisposition […] Women most susceptible than men […] Mortality of severe alcoholic hepatitis is 50%.

• #27 Alcoholic Hepatitis Market Share | Trend 2034

  https://www.imarcgroup.com/alcoholic-hepatitis-market

  The 7 major alcoholic hepatitis markets reached a value of US$ 1.9 Billion in 2023. Looking forward, IMARC Group expects the 7MM to reach US$ 3.1 Billion by 2034, exhibiting a growth rate (CAGR) of 4.37% during 2024-2034. […] The increasing prevalence of liver diseases on account of rising alcohol consumption is primarily driving the alcoholic hepatitis market. […] According to the report the United States has the largest patient pool for alcoholic hepatitis and also represents the largest market for its treatment. […] What is the number of prevalent cases (2018-2034) of alcoholic hepatitis across the seven major markets? […] What is the size of the alcoholic hepatitis patient pool (2018-2023) across the seven major markets? […] What would be the forecasted patient pool (2024-2034) across the seven major markets? […] What are the key factors driving the epidemiological trend of alcoholic hepatitis? […] What will be the growth rate of patients across the seven major markets?

• #28 Pathophysiology and Management of Alcoholic Liver Disease: Update 2016

  https://www.gutnliver.org/journal/view.html?doi=10.5009/gnl16477

  According to WHO, morbidity attributable to alcohol in developed countries accounts for 10.3% of disability adjusted life years and comes second only to that of tobacco (11.7%). […] In 2010, alcoholic liver cirrhosis was responsible for 493,300 deaths (47.9% of all liver cirrhosis deaths), representing 0.9% of all deaths regardless the cause (0.7% of all deaths of women and 1.2% of all deaths of men), and 80,600 deaths (14,800 deaths of women and 65,900 deaths of men) were attributable to alcohol-related liver cancer. […] Apart from mere mortality figures, harmful alcohol consumption is the second most common indication for liver transplantation, accounting for approximately 40% of all primary liver transplants in Europe and about 25% in the United States. […] This huge disease burden has an economic impact of about 125 billion Euros annually in Europe, accounting for 1.3% of the gross domestic product.

• #29

  https://www.jci.org/articles/view/176345

  Among patients with ALD, the annual incidence of A-HCC is 5.6 cases per 1,000 person-years. […] Cirrhosis is a necessary intermediate step for A-HCC development and amplifies the overall risk for carcinogenesis in patients with ALD. […] ALD is a heterozygous disease characterized by a spectrum of disorders, and this heterogeneity likely contributes to the failing of various clinical trials for ALD treatment. […] There is a clear sex disparity regarding the epidemiology of ALD. Women are more susceptible to ALD than men with the same amount of alcohol intake, although the exact mechanisms are still unclear.

• #30 The Mexican consensus on alcoholic hepatitis | Revista de Gastroenterología de México

  https://www.revistagastroenterologiamexico.org/en-the-mexican-consensus-on-alcoholic-articulo-S2255534X20300542

  Alcoholic hepatitis is a frequent condition in the Mexican population. It is characterized by acute-on-chronic liver failure, important systemic inflammatory response, and multiple organ failure. The severe variant of the disease implies elevated mortality. […] The primary aim of the present consensus was to formulate a document containing descriptions and analyses of the current evidence on the basic concepts, epidemiology, diagnosis, and treatment of AH, with a focus on their application in daily clinical practice in Mexico. […] According to the World Health Organization (WHO), 50% of deaths by cirrhosis worldwide are related to alcohol consumption. In 2013, more than 23,000 persons died from cirrhosis in Mexico, and almost three-quarters of those deaths were in men. Cirrhosis of the liver is the fourth cause of loss of health in Mexico and accumulates 4.1% of the disease burden, according to the disability-adjusted life year (DALY) indicator.

• #30 The Mexican consensus on alcoholic hepatitis | Revista de Gastroenterología de México

  https://www.revistagastroenterologiamexico.org/en-the-mexican-consensus-on-alcoholic-articulo-S2255534X20300542

  The severity of alcoholic hepatitis should be established, as it defines the type of treatment to administer. […] Alcohol abstinence is the most important prognostic factor for long-term survival in patients with alcoholic hepatitis. In the short term, mortality is determined by causes related to inflammatory response, liver injury (variceal bleeding, portal hypertension), infections, and organ failure. […] Liver transplantation can be considered a therapeutic option in selected cases of severe alcoholic hepatitis.

• #31 Alcohol-related liver disease (ARLD) – British Liver Trust

  https://britishlivertrust.org.uk/information-and-support/liver-conditions/alcohol-related-liver-disease/

  Alcohol consumption is the most common cause of liver disease in the UK, accounting for 6 in 10 cases of liver disease. Up to 1 in 5 people in the UK drink alcohol in a way that could harm their liver. […] This stage of alcohol-related liver disease is very serious, and about a third of heavy drinkers with alcohol-related fatty liver will start to develop it. […] Its really important to have regular appointments with your doctor or specialist so they can monitor your condition. […] If you have alcohol-related fatty liver, the damage may be reversed if you stop for a period of time (months or years). […] If you have a more serious form of alcohol-related liver disease, such as alcohol-related hepatitis or cirrhosis, your doctor will advise you to stop drinking completely (lifelong abstinence) to prevent further damage. […] Its important to keep your weight healthy, as this helps stop more damage to your liver. Carrying extra bodyweight can cause liver damage too. […] If you have later stage liver disease its really important to ask your liver specialist about having a transplant.

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