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Review
. 2021 Aug;25(3):537-555.
doi: 10.1016/j.cld.2021.03.001. Epub 2021 May 27.

Moderate Alcoholic Hepatitis

Ana Clemente-Sánchez  1 , Aline Oliveira-Mello  2 , Ramón Bataller  3
Affiliations
Review

Moderate Alcoholic Hepatitis

Ana Clemente-Sánchez et al. Clin Liver Dis. 2021 Aug.

Abstract

The natural history of moderate alcoholic hepatitis (AH) is not well known. It is a frequent disease with a probable underestimated incidence compared with its severe form. Among the different prognostic scores predicting short-term mortality in AH, MELD seems to be the most accurate. The mortality of moderate AH is 3% to 7% in the short to medium term and 13% to 20% at 1 year, mainly because of liver-related complications, including severe infections. Long-term abstinence is the main goal of the treatment. There is still need for the development of new therapies for AH, including the less severe forms.

Keywords: Abstinence; Alcoholic hepatitis; MELD; Moderate; Nonsevere; Survival.

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Figures

Figure 1.
Figure 1.. The spectrum of alcoholic liver disease.
Abbreviations: ASH, Alcoholic steatohepatitis; HCC, Hepatocellular carcinoma.
Figure 2.
Figure 2.. Algorithm of the general diagnostic approach in AH.
(Data from Refs,,,) Abbreviations: AH, Alcoholic hepatitis; ALT, Alanine aminotransferase; ANA, Antinuclear antibody; ASMA, Anti smooth-muscle antibody; AST, Aspartate aminotransferase; CT, Computed tomography; DILI, Drug-induced liver injury; GGT, Gamma-glutamyl transferase; HCC, hepatocellular carcinoma; IgG, Immunoglobulin G; MRCP, Magnetic resonance cholangiopancreatography; MRI, Magnetic resonance imaging; SIRS, Systemic inflammatory response syndrome; TJLB, Transjugular liver biopsy.
Figure 3.
Figure 3.. Suggested algorithm for the management of moderate AH.
Data from Refs,, Abbreviations: AH, Alcoholic hepatitis; AKI, Acute kidney injury; AUD, Alcohol Use Disorder; AUDIT, Alcohol Use Disorders Inventory Test; Child-P, Child-Pugh; HCC, Hepatocellular carcinoma; MELD, Model for End-Stage Liver Disease; NIAAA, National Institute on Alcohol Abuse and Alcoholism; SBP, Spontaneous bacterial peritonitis.
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