Am Fam Physician. 2025;111(3):284-286
Author disclosure: No relevant financial relationships.
KEY POINTS FOR PRACTICE
• Patients should be screened for heavy drinking at every visit using the three-question AUDIT-C.
• Blood tests, such as the Fibrosis-4 test, or vibration-controlled transient elastography are recommended to assess fibrosis severity.
• In patients with ALD, alcohol use should be addressed at every visit using motivational interviewing techniques, with a goal of a reduction in or abstinence from alcohol use.
• For patients with severe alcohol-associated hepatitis and a MELD score greater than 20, corticosteroid treatment may reduce mortality.
From the AFP Editors
Approximately 15 in 100,000 people die of cirrhosis annually in the United States, and one-half of these deaths are associated with alcohol use. The prevalence of severe forms of alcohol-associated liver disease (ALD) is increasing in younger people, women, and Hispanic and Native American people. Liver transplants for alcohol-associated hepatitis have increased fourfold in those younger than 40 years. Rates of alcohol use and ALD-related mortality increased during the COVID-19 pandemic. The American College of Gastroenterology has released guidelines for management of ALD.
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