User:Rochni/sandbox/Introduction

= Types of Liver Disease =

Also known as hepatic disease. Liver disease is defined as chronic if it lasts over six months.


 * Hepatitis: inflammation of the liver
 * Viral hepatitis
 * Fatty liver disease (hepatic steatosis)
 * Alcoholic liver disease
 * Non-alcoholic fatty liver disease

= Epidemiology =

Prevalence

 * General population :
 * Liver fibrosis: 0.7% to 25.7%
 * Advanced liver fibrosis: 0.9-2.0%
 * Cirrhosis: 0.1-1.7%
 * NASH, hazardous alcohol use or T2D subset :
 * Advanced liver fibrosis: 0-27.9%
 * Cirrhosis: 2.4-4.0%

Mortality

 * Worldwide:
 * Cirrhosis and chronic liver disease: 2% in 2015 (up 10.3% from 2005)

= Current Areas of Interest =

Stratifying Risk
Determining the degree to which someone is at risk of developing liver disease is of clear clinical importance. Currently, liver disease is often tested for using invasive methods, an obvious disadvantage of which is patient discomfort. As a result, these tests are often avoided until symptoms are already starting to show; 50% of cirrhosis diagnoses are only made once the patient has already been hospitalised for a decompensating liver event. They additionally often have poor sensitivity and specificity. Non-invasive test are thus preferable when available, and often identify liver disease which abnormal liver function tests have overlooked. These make it possible to identify disease - and the risk of disease - the general population.

Non-Invasive Tests for Liver Disease
Note that the European Association for the Study of the Liver (EASL) has published guidelines for clinical use of non-invasive tests.


 * Transient elastography
 * FibroTest
 * AST to ALT ratio
 * APRI
 * BARD
 * FIB4
 * NAFLD fibrosis score
 * Hyaluronic acid (aka hyaluronan)
 * BAAT
 * ELF score
 * Southampton traffic light test

Invasive Tests for Liver Disease

 * Liver biochemistry panels (aka liver function tests)
 * Histology
 * Serum concentration of alanine aminotransferase (ALT)
 * 59% of patients with NAFLD have normal ALT

= Further Reading =

Review Articles

 * Harris, Rebecca, David J Harman, Timothy R Card, Guruprasad P Aithal, and Indra Neil Guha. 2017. “Prevalence of clinically significant liver disease within the general population, as defined by non-invasive markers of liver fibrosis: a systematic review.” Lancet Gastroenterology and Hepatology 2 (4): 288–97

= Bibliography =