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Histological Analyses of Acute Alcoholic Liver Injury in Zebrafish
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Moderate Alcoholic Hepatitis.

Ana Clemente-Sánchez1, Aline Oliveira-Mello2, Ramón Bataller3

  • 1Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Pittsburgh Medical Center (UPMC), BST West 11th Floor, Suite 1116-17, 200 Lothrop Street, Pittsburgh, PA 15213, USA; CIBERehd, Instituto de Salud Carlos III, Avenida Monforte de Lemos, 3-5, Pavilion 11th, Floor 0, Madrid 28029, Spain.

Clinics in Liver Disease
|July 7, 2021
PubMed
Summary

Moderate alcoholic hepatitis (AH) is common, with short-term mortality of 3-7% and 1-year mortality of 13-20%. Long-term abstinence is key, and new therapies are needed for all forms of AH.

Keywords:
AbstinenceAlcoholic hepatitisMELDModerateNonsevereSurvival

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Area of Science:

  • Hepatology
  • Gastroenterology
  • Internal Medicine

Background:

  • Moderate alcoholic hepatitis (AH) is a frequent liver disease with an underestimated incidence.
  • The natural history and prognosis of moderate AH require further elucidation.
  • Existing prognostic scores for AH, such as MELD, are primarily validated for severe forms.

Purpose of the Study:

  • To describe the natural history and outcomes of moderate alcoholic hepatitis.
  • To evaluate the accuracy of prognostic scores in predicting mortality for moderate AH.
  • To highlight the current treatment goals and therapeutic gaps in managing moderate AH.

Main Methods:

  • Review of existing literature on the natural history and management of moderate alcoholic hepatitis.
  • Analysis of prognostic scores, particularly MELD, for their applicability to moderate AH.
  • Synthesis of data on mortality rates and complications associated with moderate AH.

Main Results:

  • Short-term mortality for moderate AH ranges from 3% to 7%, with 1-year mortality between 13% and 20%.
  • Liver-related complications, especially severe infections, are primary causes of mortality.
  • The Model for End-Stage Liver Disease (MELD) score demonstrates accuracy in predicting short-term mortality in AH.

Conclusions:

  • Moderate alcoholic hepatitis carries significant short- and medium-term mortality risks.
  • Long-term alcohol abstinence remains the cornerstone of treatment for alcoholic hepatitis.
  • There is an unmet need for novel therapeutic strategies for both moderate and severe forms of alcoholic hepatitis.