title: Alcoholic hepatitis: Prognosis and treatment.
abstract: Alcoholic hepatitis (AH) is a type of acute-on-chronic liver failure and is the most severe form of alcoholic liver disease. AH occurs in patients with heavy alcohol abuse and underlying liver disease. In its severe form, AH carries a poor short-term prognosis. Although the existence of AH can be strongly suspected based on clinical and biochemical criteria, a definitive diagnosis requires a liver biopsy. There is a clear need to develop non-invasive markers for these patients. The prognosis of patients with AH can be established by different score systems (Maddrey's DF, ABIC, MELD and Glasgow). Recently, a histological scoring system able to estimate prognosis has been developed (Alcoholic Hepatitis Histological Score - AHHS). The management of patients with AH has changed little in the last few decades. In patients with severe form of AH, prednisolone and pentoxifylline are the first line therapy. Unfortunately, many patients do not respond and novel targeted therapies are urgently needed. Current research is aimed at identifying the main disease drivers and to develop animal models of true AH. For non-responders to medical therapy, the only curative option is to perform a salvage liver transplantation. This particular indication of liver transplantation is currently under debate and prospective studies should evaluate the specific patient evaluation and selection criteria.
authors.affiliation: Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Casanova
authors.affiliation: Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC, USA; Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina at Chapel Hill, NC, USA. Electronic address: ramon_bataller@med.unc.edu.
authors.forename: Ramón
authors.initials: R
authors.lastname: Bataller
mesh_terms: D000427:Alcohol Deterrents / Q000627:therapeutic use; D000818:Animals; D000911:Antibodies, Monoclonal / Q000494:pharmacology / Q000627:therapeutic use; D004195:Disease Models, Animal; D000068800:Etanercept; D005235:Fatty Liver, Alcoholic / Q000209:etiology / Q000473:pathology; D006519:Hepatitis, Alcoholic / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D006801:Humans; D007074:Immunoglobulin G / Q000494:pharmacology / Q000627:therapeutic use; D015994:Incidence; D000069285:Infliximab; D008099:Liver / Q000473:pathology; D017093:Liver Failure / Q000209:etiology / Q000401:mortality / Q000517:prevention & control; D016031:Liver Transplantation; D044342:Malnutrition / Q000178:diet therapy / Q000209:etiology; D010431:Pentoxifylline / Q000494:pharmacology / Q000627:therapeutic use; D011239:Prednisolone / Q000627:therapeutic use; D011379:Prognosis; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use; D012436:S-Adenosylmethionine / Q000627:therapeutic use; D012720:Severity of Illness Index; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D000427:Alcohol Deterrents; D000911:Antibodies, Monoclonal; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D012436:S-Adenosylmethionine; D011239:Prednisolone; D000069285:Infliximab; D000068800:Etanercept; D010431:Pentoxifylline
keywords: Alcoholic liver disease; Clinical guidelines; Guía clínica; Hepatopatía alcohólica; Liver transplantation; Trasplante hepático