Alcoholic liver fibrosis: detection and treatment

Minerva medica
Gianni TestinoRinaldo Pellicano

Abstract

Alcohol consumption is one of the main risks to public health. Alcohol use disorders (AUDs) cause 80% of hepatotoxic deaths, and approximately 50% of cirrhosis is alcohol-related. The acceptable daily intake (ADI) for ethanol is 2.6 g/day, deduced from morbidity and mortality rates due to liver fibrosis. The relative risk of cirrhosis increases significantly for doses above 60 g/day for men and 20 g/day for women over a period of around 10 years. Twenty to 40% of steatosis cases will evolve into steatohepatitis/steatofibrosis, and 8 to 20% will evolve directly into liver cirrhosis. About 20 to 40% of steatohepatitis cases will evolve into cirrhosis, and 4 to 5% into hepatocellular carcinoma. This cascade of events evolves in 5 to 40 years, with the temporal variability caused by the subjects' genetic patterns and associated risk/comorbidity factors. Steatohepatitis should be considered "the rate limiting step:" usually, it can be resolved through abstinence, although for some patients, once this situation develops, it is not substantially modified by abstention and there is a risk of fibrotic evolution. Early detection of fibrosis, obtained by hepatic elastography, is a crucial step in patients with AUDs. Such strategy allows p...Continue Reading

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Citations

Feb 21, 2019·Minerva medica·Gianni TestinoRinaldo Pellicano
Feb 13, 2019·Minerva gastroenterologica e dietologica·Gianni TestinoRinaldo Pellicano
Feb 13, 2019·Minerva gastroenterologica e dietologica·Gianni TestinoRinaldo Pellicano
Feb 21, 2019·Minerva medica·Gianni TestinoRinaldo Pellicano
Mar 11, 2020·Medicina·Joice Anaize Tonon do AmaralAna Cristina Aoun Tannuri
Mar 19, 2020·Minerva ginecologica·Gianni Testino, Rinaldo Pellicano
Mar 29, 2020·Minerva gastroenterologica e dietologica·Gianni Testino
Mar 3, 2021·Scandinavian Journal of Gastroenterology·Gianni TestinoRinaldo Pellicano
Jun 15, 2021·Frontiers in Physiology·Yu-Long BaoShao-Wei Li
Apr 2, 2021·Minerva Gastroenterology·Gianni Testino, Rinaldo Pellicano
May 18, 2020·Panminerva Medica·Gianni Testino, Sharmila Fagoonee

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