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. 2019 Feb;15(2):83-89.

Diagnostic and Treatment Implications of Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis

Terrence Wong  1   2   3 , Robert J Wong  1   2   3 , Robert G Gish  1   2   3
Affiliations

Diagnostic and Treatment Implications of Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis

Terrence Wong et al. Gastroenterol Hepatol (N Y). 2019 Feb.

Abstract

Nonalcoholic fatty liver disease (NAFLD) affects 75 to 100 million adults in the United States and is the leading cause of chronic liver disease worldwide, fueled by the rising epidemic of obesity and metabolic syndrome. NAFLD is the hepatic manifestation of metabolic syndrome; thus, accurately assessing and managing comorbid metabolic syndrome components is paramount. Nonalcoholic steatohepatitis (NASH) is a subset of NAFLD that includes a more progressive and advanced form of the disease, with a greater risk of fibrosis progression. Correctly diagnosing and staging NAFLD and distinguishing the subset of NASH patients is not only critical for disease monitoring and prognostication, but also holds potential implications for therapies. Although the current therapeutic landscape for NAFLD does not offer many options, future therapies are on the horizon. Properly staging the severity of disease and fibrosis is especially important when considering the eligibility and cost-effectiveness of these therapies.

Keywords: Nonalcoholic fatty liver disease; cirrhosis; fibrosis; hepatic steatosis; nonalcoholic steatohepatitis.

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Conflict of interest statement

Dr Terrence Wong has no relevant conflicts of interest to disclose. Dr Robert J. Wong has received research funding from AbbVie and Gilead Sciences; is on the speakers bureau for Bayer, Gilead Sciences, and Salix Pharmaceuticals; and is on the advisory board and has served as a consultant to Gilead Sciences. He is also funded by the American Association for the Study of Liver Diseases Foundation Clinical and Translational Research Award in Liver Diseases. Dr Gish has received grants and/or research support from AbbVie, Benitec Biopharma, Gilead Sciences, and Merck. Over the last 2 years, he has served as a consultant and/or advisor to Abbott Laboratories, AbbVie, Alexion Pharmaceuticals, Arrowhead Pharmaceuticals, Bayer, Bristol-Myers Squibb, ContraVir Pharmaceuticals, Eiger BioPharmaceuticals, ENYO Pharma, eStudySite, Genentech, Gilead Sciences, HepaTx, HepQuant, Hoffmann-La Roche, Intellia Therapeutics, Intercept Pharmaceuticals, Ionis Pharmaceuticals, Janssen, MedImmune, Merck, Shionogi, Transgene, and Trimaran Pharma. Dr Gish has current activity with the scientific or clinical advisory board of AbbVie, Arrowhead Pharmaceuticals, Bayer, ContraVir Pharmaceuticals, Dova Pharmaceuticals, Eiger BioPharmaceuticals, ENYO Pharma, Janssen, Janssen/Johnson & Johnson, Intercept Pharmaceuticals, MedImmune, Merck, Shionogi, and Spring Bank Pharmaceuticals, and is a member of the speakers bureau for AbbVie, Bristol-Myers Squibb, Gilead Sciences, and Merck. Dr Gish is also a minor stock shareholder of Cocrystal Pharma.

Figures

Figure.
Figure.
Cascade of disease progression among individuals with nonalcoholic fatty liver disease. The dotted line demonstrates the increasing evidence of hepatocellular carcinoma in noncirrhotic patients with nonalcoholic steatohepatitis.
See this image and copyright information in PMC

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