Alcohol-associated liver disease-Global epidemiology

Area of Science:

• Hepatology
• Public Health
• Epidemiology

Background:

• Alcohol-associated liver disease (ALD) represents a major global health concern, contributing significantly to disease burden and premature mortality.
• In 2019, ALD resulted in 11 million life-years lost worldwide, with alarming increases in deaths and disability-adjusted life-years, particularly in the United States.
• ALD is increasingly affecting younger adults and is the leading cause of liver transplantation in the US and Europe, with trends exacerbated by the COVID-19 pandemic.

Purpose of the Study:

• To review the current understanding of alcohol-associated liver disease (ALD) as a significant public health issue.
• To highlight the increasing prevalence, mortality, and economic impact of ALD globally and in specific regions like the United States.
• To underscore the challenges in accurately assessing ALD's impact and emphasize the need for improved public health strategies.

Main Methods:

• This study is a narrative review synthesizing existing literature on alcohol-associated liver disease.
• It examines epidemiological data, disease burden statistics, and mortality rates associated with ALD.
• The review also considers methodological challenges in ALD assessment and the impact of alcohol on other liver conditions.

Main Results:

• ALD is a growing public health crisis with substantial global mortality and economic costs, projected to double in the US by 2040.
• Prevalence is high among hazardous drinkers (26.0%) and those with alcohol use disorders (55.1%), with 5-year mortality exceeding 50% in affected patients.
• ALD is increasingly prevalent in younger adults and is the leading cause for liver transplants in the US and Europe, with a notable rise during the COVID-19 pandemic.

Conclusions:

• Addressing the escalating crisis of alcohol-associated liver disease requires immediate and robust public health initiatives.
• Enhanced awareness, improved diagnostic techniques, and comprehensive epidemiological studies are crucial for mitigating ALD's impact.
• Accurate assessment and acknowledgment of alcohol's role in liver disease progression are vital for effective healthcare strategies and reducing the burden on individuals and health systems.