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Erschienen in:
19.09.2018 | Fatty Liver Disease (Z Younossi, Section Editor)
The Clinical and Economic Burden of Nonalcoholic Steatohepatitis
Erschienen in: Current Hepatology Reports | Ausgabe 4/2018
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Purpose of review
Nonalcoholic fatty liver disease (NAFLD) will be the dominant and most impactful liver disease for the next generation. As the obesity and diabetes epidemic continues and the general populations in most industrialized countries become older, NAFLD and its progressive subtype nonalcoholic steatohepatitis (NASH) will have a significant clinical and economic impact on society, both in the USA and globally. This manuscript provides a review of recently published articles that detail the impact of NAFLD and NASH.
Recent findings
Overall, the literature shows that NAFLD is the most common liver disease globally, and that NASH is poised to become one of the dominant drivers of cirrhosis and hepatocellular carcinoma. Decompensated cirrhosis due to NASH will soon be the leading indication for liver transplantation. Costs increase significantly as patients progress to later stages of liver disease. Overall, the annual direct medical costs related to NAFLD are estimated to be near $100 billion in the USA and over €35 billion in Europe. The price tag almost triples if indirect costs are included. The global impact of NAFLD and NASH is projected to increase, with a 178% increase in liver-related deaths by 2030.
Summary
The clinical and economic impact of NAFLD and NASH will be immense in the upcoming decades. This highlights the great need for better screening, surveillance, linkage to care, risk stratification, and treatment options.