Prevention of Alcohol-Associated Liver Disease.

Abstract

Alcohol-associated liver disease (ALD) is the leading cause of morbidity, disease-adjusted life years lost, and mortality worldwide. The significant burden and cost to the healthcare systems from ALD are largely preventable, given that alcohol use is the most important determinant of risk and severity of ALD. In this article, we will review the emerging evidence for public health policies (minimum unit price of alcohol, limiting, or banning alcohol advertising), aiming to reduce the availability of alcohol at the population level (primary prevention), preventing ALD especially advanced form of cirrhosis in at-risk individuals (secondary prevention), and improving liver outcomes and long-term survival in patients with advanced ALD of cirrhosis and/or alcohol-associated hepatitis (tertiary prevention). We will highlight the critical role of clinicians in promoting the public health policies, widespread screening for alcohol use disorder and for ALD, and integrating liver with addiction care for patients with ALD.