Overview
Alcohol-associated hepatitis (AH) is a life-threatening condition characterized by acute liver inflammation in the setting of recent heavy alcohol consumption 1. Prognosis remains poor, with high short-term mortality 1.Diagnosis
Diagnosis is based on clinical presentation, laboratory findings, and exclusion of other causes of liver disease 1.
Key features include jaundice, elevated liver enzymes (AST > ALT, typically <500 IU/L), and elevated bilirubin 1.
Severity assessment is crucial for guiding management 1.Management
The cornerstone of management is complete abstinence from alcohol 1.
Nutritional support is essential 1.
Corticosteroids are often used in severe cases to reduce inflammation 1.
Antiviral therapy may be considered in patients with coexisting viral hepatitis 1.
Liver transplantation is an option for select patients with severe AH who achieve sustained abstinence 1.Key Recommendations
Short-term mortality in severe alcohol-associated hepatitis remains high and has not improved in recent decades 1. (Evidence: Moderate)
There is an urgent need for effective therapies for alcohol-associated hepatitis 1. (Evidence: Moderate)
Improved patient selection for early liver transplantation is needed for patients with severe alcohol-associated hepatitis 1. (Evidence: Moderate)
Better prognostic tools are required to guide clinical decision-making in alcohol-associated hepatitis 1. (Evidence: Moderate)References
1 Siddique MR, Haque M, Idalsoaga F, Diaz LA, Im G, Singal AK et al.. Meta-Analysis: Mortality Trends and Risk Factors in Severe Alcohol-Associated Hepatitis. Alimentary pharmacology & therapeutics 2025. link