Alcoholic hepatitis primary prevention

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shadan Mehraban, M.D.[2]

Overview

The primary prevention of Alcoholic Hepatitis is alcohol abstinence.Alcohol abstinence improves histological features of hepatic injury and reduces portal hypertension and the risk of cirrhosis. Risk of recidivism is 67% to 81% after alcohol abstinence; therefore, combination psychotherapy with cognitive behavioral therapy, peer driven support counseling, motivational enhancement therapy, and comprehensive medical care.

Primary Prevention

The primary prevention of Alcoholic Hepatitis is alcohol abstinence^[1]
- Alcohol abstinence improves histological features of hepatic injury and reduces portal hypertension and the risk of cirrhosis^[2]
- In two-third of patients improvement can be seen in 90 days^[3]
Risk of recidivism is 67% to 81% after alcohol abstinence ^[4]
In order to decrease the risk of recidivism, following interventions are recommended:^[5]
- Combination psychotherapy with cognitive behavioral therapy
- Peer driven support counseling
- Motivational enhancement therapy
- Comprehensive medical care

References

↑ Pessione F, Ramond MJ, Peters L, Pham BN, Batel P, Rueff B; et al. (2003). “Five-year survival predictive factors in patients with excessive alcohol intake and cirrhosis. Effect of alcoholic hepatitis, smoking and abstinence”. Liver Int. 23 (1): 45–53. doi:10.1034/j.1600-0676.2003.01804.x. PMID 12640727.
↑ O’Shea RS, Dasarathy S, McCullough AJ (2010). “Alcoholic liver disease”. Am J Gastroenterol. 105 (1): 14–32, quiz 33. doi:10.1038/ajg.2009.593. PMID 19904248.
↑ Veldt BJ, Lainé F, Guillygomarc’h A, Lauvin L, Boudjema K, Messner M; et al. (2002). “Indication of liver transplantation in severe alcoholic liver cirrhosis: quantitative evaluation and optimal timing”. J Hepatol. 36 (1): 93–8. doi:10.1016/s0168-8278(01)00228-8. PMID 11804670.
↑ Miller WR, Walters ST, Bennett ME (2001). “How effective is alcoholism treatment in the United States?”. J Stud Alcohol. 62 (2): 211–20. doi:10.15288/jsa.2001.62.211. PMID 11327187.
↑ Khan A, Tansel A, White DL, Kayani WT, Bano S, Lindsay J; et al. (2016). “Efficacy of Psychosocial Interventions in Inducing and Maintaining Alcohol Abstinence in Patients With Chronic Liver Disease: A Systematic Review”. Clin Gastroenterol Hepatol. 14 (2): 191-202.e1-4, quiz e20. doi:10.1016/j.cgh.2015.07.047. PMC 4805368. PMID 26256464.

Overview