Management of liver diseases: Current perspectives

Area of Science:

• Hepatology
• Gastroenterology
• Internal Medicine

Background:

• Increasing global incidence and prevalence of acute and chronic liver diseases (CLDs) significantly impact patient quality of life and can lead to life-threatening complications.
• While antivirals control hepatitis B and direct-acting antivirals reduce hepatitis C burden, challenges remain due to drug resistance and rising IV drug abuse.
• Non-alcoholic fatty liver disease (NAFLD) and alcohol-related liver disease (ARLD) are increasing, lacking specific drug cures beyond risk factor management. Genetic factors also influence CLD progression.

Purpose of the Study:

• To summarize the current epidemiological landscape of liver diseases.
• To review recent advances in the diagnosis and treatment of CLDs and their major complications.
• To highlight the impact of the COVID-19 pandemic on liver disease outcomes and liver transplantation.

Main Methods:

• Comprehensive literature review of recent epidemiological data on liver diseases.
• Analysis of current diagnostic tools and therapeutic strategies for CLDs.
• Examination of management protocols for complications such as liver fibrosis, portal hypertension, hepatocellular carcinoma (HCC), and post-liver transplantation (LT) care.

Main Results:

• Despite therapeutic advances, the overall burden of CLDs, including NAFLD and ARLD, continues to rise globally.
• Increased patient lifespan due to better complication management has led to a higher incidence of hepatocellular carcinoma (HCC) and increased demand for liver transplantation (LT).
• The COVID-19 pandemic has adversely affected outcomes for patients with CLDs and those undergoing LT, alongside causing acute hepatitis.

Conclusions:

• Effective diagnostics and therapeutics are available for liver fibrosis, portal hypertension, HCC, and post-LT management, with numerous drugs in clinical trials.
• Continued research and development are crucial for addressing the growing global burden of liver diseases and improving patient outcomes.
• A multi-faceted approach including risk factor control, advanced diagnostics, and novel therapeutics is essential for managing the complex spectrum of liver diseases.