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[Alcohol-associated hepatitis : 2025 update for the clinician]
Guillaume Mellina1, Damien Le Peillet1, Pierre-Auguste Petignat1
1Service de médecine interne générale, Centre hospitalier du Valais romand, Hôpital de Sion, 1951 Sion.
None:
Alcohol-associated hepatitis, the new term that has replaced "alcoholic hepatitis", is the most severe form of alcohol-related liver disease, with a 1-month mortality of 30 to 50% in severe cases. The diagnosis is now mainly clinical, with liver biopsy reserved for atypical presentations. The MELD (Model for End-Stage Liver Disease) 3.0 and the Lille score calculated from day 4 allow for dynamic prognostic stratification. In eligible patients, prednisolone at a dose of 40 mg/day for 28 days remains the standard treatment. Nutritional and addiction management are major determinants of survival, while early liver transplantation, without an arbitrary abstinence period, is a rescue option for carefully selected non-responders.
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