Reducing alcohol-associated liver disease burden in the general population

Area of Science:

• Hepatology
• Addiction Medicine
• Public Health

Background:

• Alcohol use disorder (AUD) and alcohol-associated liver disease (ALD) prevalence is increasing.
• A multistakeholder workshop addressed reducing the burden of ALD.
• Addressing ALD requires population-based screening, early recognition, and multidisciplinary treatment.

Purpose of the Study:

• To outline a multipronged approach for reducing ALD morbidity and mortality.
• To recommend screening tools and diagnostic pathways for AUD and ALD.
• To highlight effective care models for AUD and ALD management.

Main Methods:

• Utilizing alcohol use disorders identification test for consumption (AUDIT-C) for AUD screening.
• Employing non-invasive blood-based tests like Fibrosis-4 index for fibrosis screening in elevated AUDIT-C cases.
• Recommending sequential blood-based and imaging-based non-invasive liver disease assessment.

Main Results:

• AUDIT-C is a recommended screening tool for alcohol use.
• Non-invasive fibrosis screening is advised for elevated AUDIT-C scores.
• Integrated care, multidisciplinary clinics, and substance use navigators improve AUD and ALD outcomes.

Conclusions:

• A comprehensive strategy involving screening, intervention, and integrated care is crucial for managing AUD and ALD.
• Early detection and multidisciplinary treatment are key to reducing ALD burden.
• Success markers include reduced alcohol consumption, lower morbidity/mortality, and decreased healthcare costs.