Steatotic liver disease in Latin America: current views and perspectives

Metabolic dysfunction-associated steatotic liver disease, alcohol-associated liver disease and metabolic dysfunction and alcohol-related liver disease represent the principal subtypes of steatotic liver disease (SLD), together constituting a rapidly growing global health challenge. Latin America bears a disproportionately high burden of SLD, driven by the convergence of increasing prevalence of obesity and type 2 diabetes, high levels of harmful alcohol consumption, and a high frequency of genetic risk variants, particularly in the gene encoding patatin-like phospholipase domain-containing protein 3 (PNPLA3). These factors interact synergistically to accelerate disease progression, increasing the risk of steatohepatitis, advanced fibrosis, cirrhosis and hepatocellular carcinoma. Despite this substantial burden, the region faces major structural and health-system constraints, including fragmented health-care delivery, limited hepatology capacity, restricted access to diagnostic and therapeutic technologies, and low participation in clinical trials, all of which hinder early detection and the generation of region-specific evidence. This Review summarizes current data on the epidemiology and clinical burden of SLD in Latin America, identifies critical gaps in research and surveillance, and highlights priorities for prevention, harm reduction and health-system strengthening, including the implementation of effective public policies to reduce morbidity and mortality and improve health outcomes in the region.