Global differences in the management of alcohol-associated hepatitis.
Résumé
Alcohol-associated hepatitis is characterised by jaundice and malaise in individuals with excessive and chronic alcohol intake, and is associated with high short-term mortality.1 Specific treatments for alcohol-associated hepatitis are scarce, and treatment for the underlying alcohol use disorder (AUD) is often neglected in clinical practice.2 Management of severe alcohol-associated hepatitis is mainly based on supportive therapy, including nutrition and treating infections as they arise. Corticosteroids have been used to treat alcohol-associated hepatitis since the 1970s and remain the only effective treatment, although multiple studies show inadequate efficacy.1 Early liver transplantation has emerged as a novel strategy to improve survival in severe alcohol-associated hepatitis,3 yet access is not universally available.4 Little is known about international practice variations in managing alcohol-associated hepatitis. We aimed to examine practice patterns regarding the treatment of alcohol-associated hepatitis and adherence to current clinical guidelines and evidence.