Vnitr Lek 2025, 71(3):E11-E16 | DOI: 10.36290/vnl.2025.037

Acute alcoholis hepatitis

Markéta Štajnerová1, Stanislav Ševela1, Karolína Hronová2, Marek Šatný1
1 IV. Interní klinika a 1. LF UK a VFN, Praha
2 Klinická farmakologie a farmacie 1. LF UK a VFN, Praha

Acute alcoholic hepatitis is a life-threatening condition with an unfavorable prognosis, characterized by jaundice and acute deterioration of liver function in the context of proven alcohol abuse. Prior to initiating therapy, it is essential to exclude other potential etiologies and assess disease severity using validated scoring systems. To date, systemic corticosteroid therapy remains the only specific treatment recommended for severe hepatitis. Supportive care is indispensable and should be provided to all patients. Numerous other pharmacological agents and interventions are under investigation, some of which show promising potential.

Keywords: alcoholic hepatitis, acute-on-chronic liver failure, corticotherapy, nutritional support, liver transplantation, plasma exchange.

Accepted: April 28, 2025; Published: May 16, 2025  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Štajnerová M, Ševela S, Hronová K, Šatný M. Acute alcoholis hepatitis. Vnitr Lek. 2025;71(3):E11-16. doi: 10.36290/vnl.2025.037.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. Sandahl TD, Jepsen P, Thomsen KL, Vilstrup H. Incidence and mortality of alcoholic hepatitis in Denmark 1999-2008: a nationwide population based cohort study. J Hepatol. 2011;54(4):760-4. Go to original source... Go to PubMed...
    2. EASL Clinical Practice Guidelines: Management of alcohol-related liver disease. J Hepatol. 2018;69(1):154-81. Go to original source... Go to PubMed...
    3. Mellinger JL, Shedden K, Winder GS, Tapper E, Adams M, Fontana RJ, et al. The high burden of alcoholic cirrhosis in privately insured persons in the United States. Hepatology. 2018;68(3):872-82. Go to original source... Go to PubMed...
    4. Betrapally NS, Gillevet PM, Bajaj JS. Changes in the Intestinal Microbiome and Alcoholic and Nonalcoholic Liver Diseases: Causes or Effects? Gastroenterology. 2016;150(8):1745-55.e3. Go to original source... Go to PubMed...
    5. Feng D, Hwang S, Guillot A, Wang Y, Guan Y, Chen C, et al. Inflammation in Alcohol-Associated Hepatitis: Pathogenesis and Therapeutic Targets. Cell Mol Gastroenterol Hepatol. 2024;18(3):101352. Go to original source... Go to PubMed...
    6. Yang AM, Inamine T, Hochrath K, et al. Intestinal fungi contribute to development of alcoholic liver disease. J Clin Invest. 2017;127(7):2829-41. Go to original source... Go to PubMed...
    7. Crabb DW, Bataller R, Chalasani NP, Kamath PS, Lucey M, Mathurin P, et al. Standard Definitions and Common Data Elements for Clinical Trials in Patients With Alcoholic Hepatitis: Recommendation From the NIAAA Alcoholic Hepatitis Consortia. Gastroenterology. 2016;150(4):785-90. Go to original source... Go to PubMed...
    8. Jonas DE, Garbutt JC, Amick HR, et al. Behavioral counseling after screening for alcohol misuse in primary care: a systematic review and meta-analysis for the U.S. Preventive Services Task Force. Ann Intern Med. 2012;157(9):645-54. Go to original source... Go to PubMed...
    9. Morales-Arráez D, Ventura-Cots M, Altamirano J, Aet al. The MELD Score Is Superior to the Maddrey Discriminant Function Score to Predict Short-Term Mortality in Alcohol-Associated Hepatitis: A Global Study. Am J Gastroenterol. 2022;117(2):301-10. Go to original source... Go to PubMed...
    10. Kalapala R, Rughwani H, Reddy DN. Artificial Intelligence in Hepatology- Ready for the Primetime. J Clin Exp Hepatol. 2023;13(1):149-61. Go to original source... Go to PubMed...
    11. Sandahl TD, Jepsen P, Ott P, Vilstrup H. Validation of prognostic scores for clinical use in patients with alcoholic hepatitis. Scand J Gastroenterol. 2011;46(9):1127-32. Go to original source... Go to PubMed...
    12. Louvet A, Naveau S, Abdelnour M, Ramond MJ, Diaz E, Fartoux L, et al. The Lille model: a new tool for therapeutic strategy in patients with severe alcoholic hepatitis treated with steroids. Hepatology. 2007;45(6):1348-54. Go to original source... Go to PubMed...
    13. Quelch D, Lingford-Hughes A, John B, et al. Promising strategies for the prevention of alcohol-related brain damage through optimised management of acute alcohol withdrawal: A focussed literature review. J Psychopharmacol. 2024:2698811241294005. Go to original source... Go to PubMed...
    14. Bischoff SC, Bernal W, Dasarathy S, et al. ESPEN practical guideline: Clinical nutrition in liver disease. Clin Nutr. 2020;39(12):3533-62. Go to original source... Go to PubMed...
    15. Shah NL, Intagliata NM, Northup PG, Argo CK, Caldwell SH. Procoagulant therapeutics in liver disease: a critique and clinical rationale. Nat Rev Gastroenterol Hepatol. 2014;11(11):675-82. Go to original source... Go to PubMed...
    16. Donnino MW, Vega J, Miller J, Walsh M. Myths and misconceptions of Wernicke's encephalopathy: what every emergency physician should know. Ann Emerg Med. 2007;50(6):715-21. Go to original source... Go to PubMed...
    17. Jophlin LL, Singal AK, Bataller R, et al. ACG Clinical Guideline: Alcohol-Associated Liver Disease. Am J Gastroenterol. 2024;119(1):30-54. Go to original source... Go to PubMed...
    18. Thursz MR, Richardson P, Allison M, et al. Prednisolone or pentoxifylline for alcoholic hepatitis. N Engl J Med. 2015;372(17):1619-28. Go to original source... Go to PubMed...
    19. Van Melkebeke L, Korf H, Tsochatzis EA, et al. Treatment of severe alcoholic hepatitis: A systematic review. Curr Opin Pharmacol. 2021;60:91-101. Go to original source... Go to PubMed...
    20. Singh S, Murad MH, Chandar AK, et al. Comparative Effectiveness of Pharmacological Interventions for Severe Alcoholic Hepatitis: A Systematic Review and Network Meta-analysis. Gastroenterology. 2015;149(4):958-70.e12. Go to original source... Go to PubMed...
    21. Lebrec D, Thabut D, Oberti F, et al. Pentoxifylline does not decrease short-term mortality but does reduce complications in patients with advanced cirrhosis. Gastroenterology. 2010;138(5):1755-62. Go to original source... Go to PubMed...
    22. Szabo G, Mitchell M, McClain CJ, et al. IL-1 receptor antagonist plus pentoxifylline and zinc for severe alcohol-associated hepatitis. Hepatology. 2022;76(4):1058-68. Go to original source... Go to PubMed...
    23. Di Martino V, Questiaux J, Lemagoarou T, et al. Granulocyte colony stimulating factor in decompensated cirrhosis, acute alcoholic hepatitis, and acute-on-chronic liver failure: A comprehensive meta-analysis of randomized controlled trials. Clin Res Hepatol Gastroenterol. 2023;47(9):102207. Go to original source... Go to PubMed...
    24. Philips CA, Ahamed R, Rajesh S, et al. Clinical outcomes and gut microbiota analysis of severe alcohol-associated hepatitis patients undergoing healthy donor fecal transplant or pentoxifylline therapy: single-center experience from Kerala. Gastroenterol Rep (Oxf). 2022;10:goac074. Go to original source... Go to PubMed...
    25. Higuera-de la Tijera F, Servín-Caamaño AI, Serralde-Zúñiga AE, et al. Metadoxine improves the three- and six-month survival rates in patients with severe alcoholic hepatitis. World J Gastroenterol. 2015;21(16):4975-85. Go to original source... Go to PubMed...
    26. Xiang X, Hwang S, Feng D, Shah VH, Gao B. Interleukin-22 in alcoholic hepatitis and beyond. Hepatol Int. 2020;14(5):667-76. Go to original source... Go to PubMed...
    27. Arab JP, Sehrawat TS, Simonetto DA, et al. An Open-Label, Dose-Escalation Study to Assess the Safety and Efficacy of IL-22 Agonist F-652 in Patients With Alcohol-associated Hepatitis. Hepatology. 2020;72(2):441-53. Go to original source... Go to PubMed...
    28. Idalsoaga F, Ayares G, Díaz LA, et al. Current and emerging therapies for alcohol-associated hepatitis. Liver Research. 2023;7(1):35-46. Go to original source... Go to PubMed...
    29. Larsen FS, Schmidt LE, Bernsmeier C, et al. High-volume plasma exchange in patients with acute liver failure: An open randomised controlled trial. J Hepatol. 2016;64(1):69-78. Go to original source... Go to PubMed...
    30. Kumar SE, Goel A, Zachariah U, et al. Low Volume Plasma Exchange and Low Dose Steroid Improve Survival in Patients With Alcohol-Related Acute on Chronic Liver Failure and Severe Alcoholic Hepatitis - Preliminary Experience. J Clin Exp Hepatol. 2022;12(2):372-8. Go to original source... Go to PubMed...
    31. Lindenger C, Castedal M, Schult A, Åberg F. Long-term survival and predictors of relapse and survival after liver transplantation for alcoholic liver disease. Scand J Gastroenterol. 2018;53(12):1553-61. Go to original source... Go to PubMed...

    Return to the content


    Vnitřní lékařství

    Madam, Sir,
    please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
    Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

    I declare:

    1. that I have met the above instruction
    2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited

    No
    Yes

    If your statement is not true, please be aware
    that brings the risk of danger to their health or the health of others.