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Alcohol-related liver disease is rarely detected at early stages compared with liver diseases of other etiologies worldwide

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dc.contributor.authorShah, Neil D.
dc.contributor.authorVentura-Cots, Meritxell
dc.contributor.authorAbraldes, Juan G.
dc.contributor.authorAlboraie, Mohamed
dc.contributor.authorAlfadhli, Ahmad
dc.contributor.authorArgemi, Josepmaria
dc.contributor.authorBadia-Aranda, Ester
dc.contributor.authorArús-Soler, Enrique
dc.contributor.authorBarritt, A. Sidney
dc.contributor.authorBessone, Fernando
dc.contributor.authorBiryukova, Marina
dc.contributor.authorCarrilho, Flair J.
dc.contributor.authorFernández, Marlen Castellanos
dc.contributor.authorDorta Guiridi, Zaily
dc.contributor.authorEl Kassas, Mohamed
dc.contributor.authorEng-Kiong, Teo
dc.contributor.authorQueiroz Farias, Alberto
dc.contributor.authorGeorge, Jacob
dc.contributor.authorGui, Wenfang
dc.contributor.authorThurairajah, Prem H.
dc.contributor.authorHsiang, John Chen
dc.contributor.authorHusić-Selimovic, Azra
dc.contributor.authorIsakov, Vasily
dc.contributor.authorKaroney, Mercy
dc.contributor.authorKim, Won
dc.contributor.authorKluwe, Johannes
dc.contributor.authorKochhar, Rakesh
dc.contributor.authorDhaka, Narendra
dc.contributor.authorMarques Da Costa, Pedro
dc.contributor.authorNabeshima Pharm, Mariana A.
dc.contributor.authorOno, Suzane K.
dc.contributor.authorReis, Daniela
dc.contributor.authorRodil, Agustina
dc.contributor.authorDomech, Caridad Ruenes
dc.contributor.authorSáez-Royuela, Federico
dc.contributor.authorScheurich, Christoph
dc.contributor.authorSiow, Way
dc.contributor.authorSivac-Burina, Nadja
dc.contributor.authorDos Santos Traquino, Edna Solange
dc.contributor.authorSome, Fatma
dc.contributor.authorSpreckic, Sanjin
dc.contributor.authorTan, Shiyun
dc.contributor.authorVorobioff, Julio
dc.contributor.authorWandera, Andrew
dc.contributor.authorWu, Pengbo
dc.contributor.authorYacoub, Mohamed
dc.contributor.authorYang, Ling
dc.contributor.authorYu, Yuanjie
dc.contributor.authorZahiragic, Nerma
dc.contributor.authorZhang, Chaoqun
dc.contributor.authorCortez-Pinto, Helena
dc.contributor.authorBataller, Ramon
dc.date.accessioned2023-02-16T15:55:32Z
dc.date.available2023-02-16T15:55:32Z
dc.date.issued2019
dc.description© 2019 by the AGA Institutept_PT
dc.description.abstractBackground & aims: Despite recent advances in treatment of viral hepatitis, liver-related mortality is high, possibly owing to the large burden of advanced alcohol-related liver disease (ALD). We investigated whether patients with ALD are initially seen at later stages of disease development than patients with hepatitis C virus (HCV) infection or other etiologies. Methods: We performed a cross-sectional study of 3453 consecutive patients with either early or advanced liver disease (1699 patients with early and 1754 with advanced liver disease) seen at 17 tertiary care liver or gastrointestinal units worldwide, from August 2015 through March 2017. We collected anthropometric, etiology, and clinical information, as well as and model for end-stage liver disease scores. We used unconditional logistic regression to estimate the odds ratios for evaluation at late stages of the disease progression. Results: Of the patients analyzed, 81% had 1 etiology of liver disease and 17% had 2 etiologies of liver disease. Of patients seen at early stages for a single etiology, 31% had HCV infection, 21% had hepatitis B virus infection, and 17% had nonalcoholic fatty liver disease, whereas only 3.8% had ALD. In contrast, 29% of patients seen for advanced disease had ALD. Patients with ALD were more likely to be seen at specialized centers, with advanced-stage disease, compared with patients with HCV-associated liver disease (odds ratio, 14.1; 95% CI, 10.5-18.9; P < .001). Of patients with 2 etiologies of liver disease, excess alcohol use was associated with 50% of cases. These patients had significantly more visits to health care providers, with more advanced disease, compared with patients without excess alcohol use. The mean model for end-stage liver disease score for patients with advanced ALD (score, 16) was higher than for patients with advanced liver disease not associated with excess alcohol use (score, 13) (P < .01). Conclusions: In a cross-sectional analysis of patients with liver disease worldwide, we found that patients with ALD are seen with more advanced-stage disease than patients with HCV-associated liver disease. Of patients with 2 etiologies of liver disease, excess alcohol use was associated with 50% of cases. Early detection and referral programs are needed for patients with ALD worldwide.pt_PT
dc.description.sponsorshipThis study was funded by the National Institute of Alcohol Abuse and Alcoholism grants U01AA021908 and U01AA020821, a scholarship grant from the Spanish Association for the Study of the Liver (M.V.-C.), and a grants NSFC 81570530 and 81370550 from the National Natural Science Foundation of China (L.Y.).pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationClin Gastroenterol Hepatol. 2019 Oct;17(11):2320-2329.e12pt_PT
dc.identifier.doi10.1016/j.cgh.2019.01.026pt_PT
dc.identifier.eissn1542-7714
dc.identifier.issn1542-3565
dc.identifier.urihttp://hdl.handle.net/10451/56355
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.relation.publisherversionhttps://www.sciencedirect.com/journal/clinical-gastroenterology-and-hepatologypt_PT
dc.subjectCirrhosispt_PT
dc.subjectMortalitypt_PT
dc.subjectNAFLDpt_PT
dc.titleAlcohol-related liver disease is rarely detected at early stages compared with liver diseases of other etiologies worldwidept_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage2329pt_PT
oaire.citation.issue11pt_PT
oaire.citation.startPage2320pt_PT
oaire.citation.titleClinical Gastroenterology and Hepatologypt_PT
oaire.citation.volume17pt_PT
person.familyNameMarques da Costa
person.familyNameCortez-Pinto
person.givenNamePedro
person.givenNameHelena
person.identifier.ciencia-idA01C-0511-C986
person.identifier.orcid0000-0002-6123-8288
person.identifier.orcid0000-0002-8537-8744
rcaap.rightsrestrictedAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublicationaa3c45f3-5f2d-4b13-9adb-a8f9d8b46674
relation.isAuthorOfPublication91fdb4b3-d491-4e67-94ff-dcf5013fa1a7
relation.isAuthorOfPublication.latestForDiscovery91fdb4b3-d491-4e67-94ff-dcf5013fa1a7

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