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Artikel: The burden of liver disease in Latin America.

Díaz, Luis Antonio / Villota-Rivas, Marcela / Barrera, Francisco / Lazarus, Jeffrey V / Arrese, Marco

2023 Band 29, Heft 3, Seite(n) 101175

Abstract: Liver disease poses a substantial burden in Latin America. This burden is primarily attributed to a high level of alcohol consumption and the increasing prevalence of risk factors associated with metabolic dysfunction-associated steatotic liver disease ( ... ...

Abstract	Liver disease poses a substantial burden in Latin America. This burden is primarily attributed to a high level of alcohol consumption and the increasing prevalence of risk factors associated with metabolic dysfunction-associated steatotic liver disease (MASLD), such as sedentary lifestyles, easy access to ultra-processed foods, obesity, and type 2 diabetes mellitus. These epidemiological trends are cause for concern, especially considering that there are significant challenges in addressing them due to disparities in access to liver disease screening and care. In this article, we aim to provide an overview of the current situation regarding liver disease in Latin America. We also discuss recent multinational proposals designed to address the growing MASLD burden via its integration into existing non-communicable diseases policies, at both local and global levels. Additionally, we emphasize the urgent need to establish effective public health policies that target both MASLD risk factors and excessive alcohol consumption. Furthermore, we discuss the development of liver transplantation programs, areas for improvement in medical education and research capabilities, and how the fostering of extensive collaboration among all stakeholders is crucial for addressing liver disease in the region.
Mesh-Begriff(e)	Humans ; Latin America/epidemiology ; Risk Factors ; Prevalence ; Cost of Illness ; Liver Diseases/epidemiology ; Alcohol Drinking/epidemiology ; Alcohol Drinking/adverse effects ; Health Policy ; Liver Transplantation
Sprache	Englisch
Erscheinungsdatum	2023-11-03
Erscheinungsland	Mexico
Dokumenttyp	Journal Article ; Review
ZDB-ID	2188733-0
ISSN	1665-2681
ISSN	1665-2681
DOI	10.1016/j.aohep.2023.101175
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Combined COVID-19 vaccination and hepatitis C virus screening intervention in marginalised populations in Spain.

Lazarus, Jeffrey V / Villota-Rivas, Marcela / Ryan, Pablo / Buti, Maria / Grau-López, Lara / Cuevas, Guillermo / Espada, José Luis / Morón, William / Palma-Álvarez, Raul Felipe / Feld, Jordan J / Valencia, Jorge

Communications medicine

2023 Band 3, Heft 1, Seite(n) 66

Abstract: Background: COVID-19 has hindered hepatitis C virus (HCV) and HIV screening, particularly in marginalised groups, who have some of the highest rates of these conditions and lowest rates of COVID-19 vaccination. We assessed the acceptability of combining ...

Abstract	Background: COVID-19 has hindered hepatitis C virus (HCV) and HIV screening, particularly in marginalised groups, who have some of the highest rates of these conditions and lowest rates of COVID-19 vaccination. We assessed the acceptability of combining HCV testing with COVID-19 vaccination in a centre for addiction services (CAS) in Barcelona and a mobile testing unit (MTU) in Madrid, Spain. Methods: From 28/09/2021 to 30/06/2022, 187 adults from marginalised populations were offered HCV antibody (Ab) testing along with COVID-19 vaccination. If HCV Ab+, they were tested for HCV-RNA. MTU participants were also screened for HIV. HCV-RNA+ and HIV+ participants were offered treatment. Data were analysed descriptively. Results: Findings show how of the 86 CAS participants: 80 (93%) had been previously vaccinated for COVID-19, of whom 72 (90%) had the full first round schedule; none had a COVID-19 vaccine booster and all received a COVID-19 vaccine; 54 (62.8%) were tested for HCV Ab, of whom 17 (31.5%) were positive, of whom all were tested for HCV-RNA and none were positive. Of the 101 MTU participants: none had been vaccinated for COVID-19 and all received a COVID-19 vaccine; all were tested for HCV Ab and HIV and 15 (14.9%) and 9 (8.9%) were positive, respectively; of those HCV Ab+, 9 (60%) were HCV-RNA+, of whom 8 (88.9%) have started treatment; 5 (55.6%) of those HIV+ had abandoned antiretroviral therapy, of whom 3 (60%) have re-started it. Conclusions: The intervention was accepted by 54 (62.8%) CAS participants and all MTU participants and can be used in marginalised communities.
Sprache	Englisch
Erscheinungsdatum	2023-05-12
Erscheinungsland	England
Dokumenttyp	Journal Article
ISSN	2730-664X
ISSN (online)	2730-664X
DOI	10.1038/s43856-023-00292-y
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Physicians' Use of Digital Health Interventions in the Management of Nonalcoholic Fatty Liver Disease.

Lazarus, Jeffrey V / Villota-Rivas, Marcela / Jiménez-González, Carolina / Santos-Laso, Alvaro / Iruzubieta, Paula / Arias-Loste, María Teresa / Rice-Duek, Lisa / Leigh, Simon / Kopka, Christopher J / Turnes, Juan / Calleja, José Luis / Crespo, Javier

Clinics in liver disease

2023 Band 27, Heft 2, Seite(n) 515–533

Abstract: Globally, the use of digital health interventions (DHIs) is expanding, along with growing scientific evidence of their effectiveness. Given the high and increasing prevalence of noncommunicable liver disease, we surveyed 295 physicians across Spain about ...

Abstract	Globally, the use of digital health interventions (DHIs) is expanding, along with growing scientific evidence of their effectiveness. Given the high and increasing prevalence of noncommunicable liver disease, we surveyed 295 physicians across Spain about their knowledge, beliefs, attitudes, practices, and access with regard to DHIs for patient care and in particular for liver diseases, including nonalcoholic fatty liver disease and nonalcoholic steatohepatitis. Physicians reported high familiarity with DHIs, although most had not recommended them in patient care. Addressing concerns, including limited available time, evidence of effectiveness, education, training, and access may contribute to an increased uptake of these technologies.
Mesh-Begriff(e)	Humans ; Non-alcoholic Fatty Liver Disease/therapy ; Non-alcoholic Fatty Liver Disease/epidemiology ; Liver ; Physicians ; Life Style ; Prevalence
Sprache	Englisch
Erscheinungsdatum	2023-04-06
Erscheinungsland	United States
Dokumenttyp	Journal Article ; Review ; Research Support, Non-U.S. Gov't
ZDB-ID	1472315-3
ISSN	1557-8224 ; 1089-3261
ISSN (online)	1557-8224
ISSN	1089-3261
DOI	10.1016/j.cld.2023.01.021
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: A cascade of care analysis on the elimination of hepatitis C from public hospitals in Madrid.

Lazarus, Jeffrey V / Villota-Rivas, Marcela / Fernández, Inmaculada / Gea, Francisco / Ryan, Pablo / López, Sonia Alonso / Guy, Danielle / Calleja, José Luis / García-Samaniego, Javier

Communications medicine

2022 Band 2, Seite(n) 20

Abstract: Background: Direct-acting antivirals can cure ≥95% of hepatitis C virus (HCV) cases, but do not reach everyone in need. This cross-sectional study analyses the HCV cascade of care (CoC) in Madrid, Spain, in high-risk patients, to inform micro- ... ...

Abstract	Background: Direct-acting antivirals can cure ≥95% of hepatitis C virus (HCV) cases, but do not reach everyone in need. This cross-sectional study analyses the HCV cascade of care (CoC) in Madrid, Spain, in high-risk patients, to inform micro-elimination measures. Methods: From September 2019 to May 2021, data from medical records were collected and analysed from six public hospitals in Madrid, including seven adult, high-risk patient groups: patients in haemodialysis or pre-dialysis programmes, co-infected with HIV, with advanced liver disease (ALD), with hereditary haematological diseases, with transplants and people who inject drugs (PWID). Results: Here we present an analysis of 3994 patients (68.8% male), 91.2% were tested for anti-HCV and 28.9% were positive. Of the total, 34.5% were tested for HCV-RNA and 62.4% of these were positive. Of those HCV-RNA positive, 98.0% were treatment-eligible: in 7.4%, treatment is ongoing and in 89.3% completed. Of the latter, 92.2% obtained a sustained virological response 12 weeks post treatment (SVR12). Of those with ongoing or completed treatment, 9.8% experienced loss to follow-up (LTFU) or had unknown SVR12, 50.3% developed hepatic and 20.3% extrahepatic complications. ALD patients had the highest proportion of HCV-RNA positives (32.5%). The lowest proportion of patients treated were PWID (85.2%). Conclusions: Almost one in ten high-risk patients in six of Madrid's public hospitals remains untested for HCV antibodies. An almost equal percentage of those untested have experienced LTFU, with the highest proportion in PWID. This approach to monitoring the HCV CoC is vital to inform measures to eliminate HCV in hospitals.
Sprache	Englisch
Erscheinungsdatum	2022-02-24
Erscheinungsland	England
Dokumenttyp	Journal Article
ISSN	2730-664X
ISSN (online)	2730-664X
DOI	10.1038/s43856-022-00077-9
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: The future of International Classification of Diseases coding in steatotic liver disease: An expert panel Delphi consensus statement.

Hagström, Hannes / Adams, Leon A / Allen, Alina M / Byrne, Christopher D / Chang, Yoosoo / Duseja, Ajay / Grønbæk, Henning / Ismail, Mona H / Jepsen, Peter / Kanwal, Fasiha / Kramer, Jennifer / Loomba, Rohit / Mark, Henry E / Newsome, Philip N / Rinella, Mary E / Rowe, Ian A / Ryu, Seungho / Sanyal, Arun / Schattenberg, Jörn M /

Serper, Marina / Sheron, Nick / Simon, Tracey G / Spearman, C Wendy / Tapper, Elliot B / Villota-Rivas, Marcela / Wild, Sarah H / Wong, Vincent Wai-Sun / Yilmaz, Yusuf / Zelber-Sagi, Shira / Åberg, Fredrik / Lazarus, Jeffrey V

Hepatology communications

2024 Band 8, Heft 2

Abstract: Background: Following the adoption of new nomenclature for steatotic liver disease, we aimed to build consensus on the use of International Classification of Diseases codes and recommendations for future research and advocacy.: Methods: Through a two- ...

Abstract	Background: Following the adoption of new nomenclature for steatotic liver disease, we aimed to build consensus on the use of International Classification of Diseases codes and recommendations for future research and advocacy. Methods: Through a two-stage Delphi process, a core group (n = 20) reviewed draft statements and recommendations (n = 6), indicating levels of agreement. Following revisions, this process was repeated with a large expert panel (n = 243) from 73 countries. Results: Consensus ranged from 88.8% to 96.9% (mean = 92.3%). Conclusions: This global consensus statement provides guidance on harmonizing the International Classification of Diseases coding for steatotic liver disease and future directions to advance the field.
Mesh-Begriff(e)	Humans ; Delphi Technique ; International Classification of Diseases ; Consensus ; Liver Diseases
Sprache	Englisch
Erscheinungsdatum	2024-02-03
Erscheinungsland	United States
Dokumenttyp	Journal Article
ISSN	2471-254X
ISSN (online)	2471-254X
DOI	10.1097/HC9.0000000000000386
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Eliminating hepatitis C on the Balearic Islands, Spain: a protocol for an intervention study to test and link people who use drugs to treatment and care.

Lazarus, Jeffrey V / Herranz, Andrea / Picchio, Camila A / Villota-Rivas, Marcela / Rodríguez, Antonia / Alonso, Juan Manuel / Moratinos, Albert / Perrotta, Antonella / Tegeo, Elisabet / Bibiloni, Francisca / Buti, Maria / Vilella, Àngels

BMJ open

2021 Band 11, Heft 10, Seite(n) e053394

Abstract: Introduction: The hepatitis C virus (HCV) is a highly infectious and deadly disease, affecting some 58 million people worldwide. Of the 1.13 million people living in the Balearic Islands, Spain, about 1350 individuals have untreated HCV. Of these, about ...

Abstract	Introduction: The hepatitis C virus (HCV) is a highly infectious and deadly disease, affecting some 58 million people worldwide. Of the 1.13 million people living in the Balearic Islands, Spain, about 1350 individuals have untreated HCV. Of these, about 1120 (83%) are estimated to be people who use drugs (PWUD), who are one of the key at-risk groups for HCV infection globally. Carrying out micro-elimination approaches focused on this population is crucial to achieve the WHO goal of eliminating HCV by 2030. Thus, the primary objective of this study is to validate a model of care that simplifies the screening and linkage to HCV care pathways for PWUD on the Balearic Islands. Methods and analysis: This intervention study will be implemented across 17 sites, in 4 different settings: addiction service centres (n=12), non-governmental organisation centres (n=3), a mobile methadone unit and a prison, with an estimated 3725 participants. Together with the healthcare staff at each centre, the intervention protocols will be adapted, focusing on four phases: recruitment and testing; linkage to care; treatment for those who test positive; and monitoring of sustained virological response 12 weeks after treatment and reinfection. The primary outcomes will be the number of tested and treated individuals and the secondary outcomes will include individuals lost at each step in the cascade of care. Descriptive analysis and multivariable logistic regression of the data will be undertaken. Ethics and dissemination: The Hospital Clínic Barcelona, Spain, Ethics Committee approved this study on 18 February 2021 (HCB/2020/2018). Findings will be disseminated through peer-reviewed publications, conference presentations and social media. The results of this study could provide a model for targeting PWUD for HCV testing and treatment in the rest of Spain and in other settings, helping to achieve the WHO HCV elimination goal.
Mesh-Begriff(e)	Antiviral Agents/therapeutic use ; Hepacivirus ; Hepatitis C/diagnosis ; Hepatitis C/drug therapy ; Hepatitis C/epidemiology ; Humans ; Pharmaceutical Preparations ; Spain/epidemiology ; Substance Abuse, Intravenous/drug therapy ; Substance Abuse, Intravenous/epidemiology ; World Health Organization
Chemische Substanzen	Antiviral Agents ; Pharmaceutical Preparations
Sprache	Englisch
Erscheinungsdatum	2021-10-21
Erscheinungsland	England
Dokumenttyp	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2021-053394
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: A Twitter discourse analysis of negative feelings and stigma related to NAFLD, NASH and obesity.

Lazarus, Jeffrey V / Kakalou, Christine / Palayew, Adam / Karamanidou, Christina / Maramis, Christos / Natsiavas, Pantelis / Picchio, Camila A / Villota-Rivas, Marcela / Zelber-Sagi, Shira / Carrieri, Patrizia

Liver international : official journal of the International Association for the Study of the Liver

2021 Band 41, Heft 10, Seite(n) 2295–2307

Abstract: Background: People with non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) are stigmatized, partly since 'non-alcoholic' is in the name, but also because of obesity, which is a common condition in this group. Stigma is ... ...

Abstract	Background: People with non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) are stigmatized, partly since 'non-alcoholic' is in the name, but also because of obesity, which is a common condition in this group. Stigma is pervasive in social media and can contribute to poorer health outcomes. We examine how stigma and negative feelings concerning NAFLD/NASH and obesity manifest on Twitter. Methods: Using a self-developed search terms index, we collected NAFLD/NASH tweets from May to October 2019 (Phase I). Because stigmatizing NAFLD/NASH tweets were limited, Phase II focused on obesity (November-December 2019). Via sentiment analysis, >5000 tweets were annotated as positive, neutral or negative and used to train machine learning-based Natural Language Processing software, applied to 193 747 randomly sampled tweets. All tweets collected were analysed. Results: In Phase I, 16 835 tweets for NAFLD and 2376 for NASH were retrieved. Of the annotated NAFLD/NASH tweets, 97/1130 (8.6%) and 63/535 (11.8%), respectively, related to obesity and 13/1130 (1.2%) and 5/535 (0.9%), to stigma; they primarily focused on scientific discourse and unverified information. Of the 193 747 non-annotated obesity tweets (Phase II), the algorithm classified 40.0% as related to obesity, of which 85.2% were negative, 1.0% positive and 13.7% neutral. Conclusions: NAFLD/NASH tweets mostly indicated an unmet information need and showed no clear signs of stigma. However, the negative content of obesity tweets was recurrent. As obesity-related stigma is associated with reduced care engagement and lifestyle modification, the main NAFLD/NASH treatment, stigma-reducing interventions in social media should be included in the liver health agenda.
Mesh-Begriff(e)	Emotions ; Humans ; Non-alcoholic Fatty Liver Disease ; Obesity ; Social Media ; Social Stigma
Sprache	Englisch
Erscheinungsdatum	2021-06-08
Erscheinungsland	United States
Dokumenttyp	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2102783-3
ISSN	1478-3231 ; 1478-3223
ISSN (online)	1478-3231
ISSN	1478-3223
DOI	10.1111/liv.14969
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel: A multisociety Delphi consensus statement on new fatty liver disease nomenclature.

Rinella, Mary E / Lazarus, Jeffrey V / Ratziu, Vlad / Francque, Sven M / Sanyal, Arun J / Kanwal, Fasiha / Romero, Diana / Abdelmalek, Manal F / Anstee, Quentin M / Arab, Juan Pablo / Arrese, Marco / Bataller, Ramon / Beuers, Ulrich / Boursier, Jerome / Bugianesi, Elisabetta / Byrne, Christopher D / Narro, Graciela E Castro / Chowdhury, Abhijit / Cortez-Pinto, Helena /

Cryer, Donna R / Cusi, Kenneth / El-Kassas, Mohamed / Klein, Samuel / Eskridge, Wayne / Fan, Jiangao / Gawrieh, Samer / Guy, Cynthia D / Harrison, Stephen A / Kim, Seung Up / Koot, Bart G / Korenjak, Marko / Kowdley, Kris V / Lacaille, Florence / Loomba, Rohit / Mitchell-Thain, Robert / Morgan, Timothy R / Powell, Elisabeth E / Roden, Michael / Romero-Gómez, Manuel / Silva, Marcelo / Singh, Shivaram Prasad / Sookoian, Silvia C / Spearman, C Wendy / Tiniakos, Dina / Valenti, Luca / Vos, Miriam B / Wong, Vincent Wai-Sun / Xanthakos, Stavra / Yilmaz, Yusuf / Younossi, Zobair / Hobbs, Ansley / Villota-Rivas, Marcela / Newsome, Philip N

Annals of hepatology

2023 Band 29, Heft 1, Seite(n) 101133

Abstract: The principal limitations of the terms NAFLD and NASH are the reliance on exclusionary confounder terms and the use of potentially stigmatising language. This study set out to determine if content experts and patient advocates were in favor of a change ... ...

Abstract	The principal limitations of the terms NAFLD and NASH are the reliance on exclusionary confounder terms and the use of potentially stigmatising language. This study set out to determine if content experts and patient advocates were in favor of a change in nomenclature and/or definition. A modified Delphi process was led by three large pan-national liver associations. The consensus was defined a priori as a supermajority (67%) vote. An independent committee of experts external to the nomenclature process made the final recommendation on the acronym and its diagnostic criteria. A total of 236 panelists from 56 countries participated in 4 online surveys and 2 hybrid meetings. Response rates across the 4 survey rounds were 87%, 83%, 83%, and 78%, respectively. Seventy-four percent of respondents felt that the current nomenclature was sufficiently flawed to consider a name change. The terms "nonalcoholic" and "fatty" were felt to be stigmatising by 61% and 66% of respondents, respectively. Steatotic liver disease was chosen as an overarching term to encompass the various aetiologies of steatosis. The term steatohepatitis was felt to be an important pathophysiological concept that should be retained. The name chosen to replace NAFLD was metabolic dysfunction-associated steatotic liver disease. There was consensus to change the definition to include the presence of at least 1 of 5 cardiometabolic risk factors. Those with no metabolic parameters and no known cause were deemed to have cryptogenic steatotic liver disease. A new category, outside pure metabolic dysfunction-associated steatotic liver disease, termed metabolic and alcohol related/associated liver disease (MetALD), was selected to describe those with metabolic dysfunction-associated steatotic liver disease, who consume greater amounts of alcohol per week (140-350 g/wk and 210-420 g/wk for females and males, respectively). The new nomenclature and diagnostic criteria are widely supported and nonstigmatising, and can improve awareness and patient identification.
Mesh-Begriff(e)	Female ; Male ; Humans ; Non-alcoholic Fatty Liver Disease/diagnosis ; Non-alcoholic Fatty Liver Disease/epidemiology ; Delphi Technique ; Ethanol ; Cardiometabolic Risk Factors ; Consensus ; Hepatomegaly
Chemische Substanzen	Ethanol (3K9958V90M)
Sprache	Englisch
Erscheinungsdatum	2023-06-24
Erscheinungsland	Mexico
Dokumenttyp	Journal Article ; Review
ZDB-ID	2188733-0
ISSN	1665-2681
ISSN	1665-2681
DOI	10.1016/j.aohep.2023.101133
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: A global action agenda for turning the tide on fatty liver disease.

Lazarus, Jeffrey V / Mark, Henry E / Allen, Alina M / Arab, Juan Pablo / Carrieri, Patrizia / Noureddin, Mazen / Alazawi, William / Alkhouri, Naim / Alqahtani, Saleh A / Anstee, Quentin M / Arrese, Marco / Bataller, Ramon / Berg, Thomas / Brennan, Paul N / Burra, Patrizia / Castro-Narro, Graciela E / Cortez-Pinto, Helena / Cusi, Kenneth / Dedes, Nikos /

Hepatology (Baltimore, Md.)

2023 Band 79, Heft 2, Seite(n) 502–523

Abstract: Background and aims: Fatty liver disease is a major public health threat due to its very high prevalence and related morbidity and mortality. Focused and dedicated interventions are urgently needed to target disease prevention, treatment, and care.: ... ...

Abstract	Background and aims: Fatty liver disease is a major public health threat due to its very high prevalence and related morbidity and mortality. Focused and dedicated interventions are urgently needed to target disease prevention, treatment, and care. Approach and results: We developed an aligned, prioritized action agenda for the global fatty liver disease community of practice. Following a Delphi methodology over 2 rounds, a large panel (R1 n = 344, R2 n = 288) reviewed the action priorities using Qualtrics XM, indicating agreement using a 4-point Likert-scale and providing written feedback. Priorities were revised between rounds, and in R2, panelists also ranked the priorities within 6 domains: epidemiology, treatment and care, models of care, education and awareness, patient and community perspectives, and leadership and public health policy. The consensus fatty liver disease action agenda encompasses 29 priorities. In R2, the mean percentage of "agree" responses was 82.4%, with all individual priorities having at least a super-majority of agreement (> 66.7% "agree"). The highest-ranked action priorities included collaboration between liver specialists and primary care doctors on early diagnosis, action to address the needs of people living with multiple morbidities, and the incorporation of fatty liver disease into relevant non-communicable disease strategies and guidance. Conclusions: This consensus-driven multidisciplinary fatty liver disease action agenda developed by care providers, clinical researchers, and public health and policy experts provides a path to reduce the prevalence of fatty liver disease and improve health outcomes. To implement this agenda, concerted efforts will be needed at the global, regional, and national levels.
Mesh-Begriff(e)	Humans ; Delivery of Health Care ; Liver Diseases
Sprache	Englisch
Erscheinungsdatum	2023-08-04
Erscheinungsland	United States
Dokumenttyp	Journal Article
ZDB-ID	604603-4
ISSN	1527-3350 ; 0270-9139
ISSN (online)	1527-3350
ISSN	0270-9139
DOI	10.1097/HEP.0000000000000545
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: A multisociety Delphi consensus statement on new fatty liver disease nomenclature.

Rinella, Mary E / Lazarus, Jeffrey V / Ratziu, Vlad / Francque, Sven M / Sanyal, Arun J / Kanwal, Fasiha / Romero, Diana / Abdelmalek, Manal F / Anstee, Quentin M / Arab, Juan Pablo / Arrese, Marco / Bataller, Ramon / Beuers, Ulrich / Boursier, Jerome / Bugianesi, Elisabetta / Byrne, Christopher D / Castro Narro, Graciela E / Chowdhury, Abhijit / Cortez-Pinto, Helena /

Hepatology (Baltimore, Md.)

2023 Band 78, Heft 6, Seite(n) 1966–1986

Abstract	The principal limitations of the terms NAFLD and NASH are the reliance on exclusionary confounder terms and the use of potentially stigmatising language. This study set out to determine if content experts and patient advocates were in favor of a change in nomenclature and/or definition. A modified Delphi process was led by three large pan-national liver associations. The consensus was defined a priori as a supermajority (67%) vote. An independent committee of experts external to the nomenclature process made the final recommendation on the acronym and its diagnostic criteria. A total of 236 panelists from 56 countries participated in 4 online surveys and 2 hybrid meetings. Response rates across the 4 survey rounds were 87%, 83%, 83%, and 78%, respectively. Seventy-four percent of respondents felt that the current nomenclature was sufficiently flawed to consider a name change. The terms "nonalcoholic" and "fatty" were felt to be stigmatising by 61% and 66% of respondents, respectively. Steatotic liver disease was chosen as an overarching term to encompass the various aetiologies of steatosis. The term steatohepatitis was felt to be an important pathophysiological concept that should be retained. The name chosen to replace NAFLD was metabolic dysfunction-associated steatotic liver disease. There was consensus to change the definition to include the presence of at least 1 of 5 cardiometabolic risk factors. Those with no metabolic parameters and no known cause were deemed to have cryptogenic steatotic liver disease. A new category, outside pure metabolic dysfunction-associated steatotic liver disease, termed metabolic and alcohol related/associated liver disease (MetALD), was selected to describe those with metabolic dysfunction-associated steatotic liver disease, who consume greater amounts of alcohol per week (140-350 g/wk and 210-420 g/wk for females and males, respectively). The new nomenclature and diagnostic criteria are widely supported and nonstigmatising, and can improve awareness and patient identification.
Mesh-Begriff(e)	Male ; Female ; Humans ; Non-alcoholic Fatty Liver Disease/diagnosis ; Non-alcoholic Fatty Liver Disease/metabolism ; Delphi Technique ; Hepatomegaly ; Surveys and Questionnaires
Sprache	Englisch
Erscheinungsdatum	2023-06-24
Erscheinungsland	United States
Dokumenttyp	Journal Article
ZDB-ID	604603-4
ISSN	1527-3350 ; 0270-9139
ISSN (online)	1527-3350
ISSN	0270-9139
DOI	10.1097/HEP.0000000000000520
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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