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Hepatologists (liver disease specialists) study and treat a variety ofacute and chronic conditions affecting this largest internal organ of thebody. The acute category includes diseases that typically result frominflammation or infection due to injurious agents such as viruses, alcohol,and drugs. The most prominent conditions - each of which may arise in anacute form but then progress to a chronic state -- are alcoholic liverdisease; hepatitis B, C, and D; non-alcoholic fatty liver disease (NAFLD);and NASH (non-alcoholic steatohepatitis, the most severe subset of NAFLD).
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The transition from an acute to a chronic state occurs when the patientfails to recover and the acute infection or disease produces ongoing damageto the liver. Cirrhosis - which refers to the death of liver cells, alteredcell regeneration, deposition of fibrous scar tissue, and ultimately theimpairment of liver function - represents the final stage of many chronicliver diseases. Cirrhosis can only partially be reversed, but treatments canstop or slow its progression. When uncontrollable complications of cirrhosisoccur, or when damage precludes sufficient liver function, a liver transplantbecomes necessary. Cirrhosis is the major risk factor for the development ofhepatocellular carcinoma (HCC), a primary cancer of liver cells, which mayalso require transplantation.
Estimates suggest 10 million carriers of viral hepatitis in Europe, ofwhich over 8 million are infected with HCV. Although statistics vary widelyby country, HCV accounts for a large (or in some countries, majority)proportion of all cases of cirrhosis and HCC. Although precise figures arenot available, alcoholic liver disease is a growing problem in both Westernand Eastern Europe, in part because of changing lifestyles and the increasingnumbers of women and adolescents who drink to excess (a problem that in thepast was largely a phenomenon of adult males). The Dionysos study, conductedin Northern Italy, reported that 4% of the population had alcoholic liverdisease of varying severity. Alcoholic liver disease is the second mostcommon indication for liver transplantation, after HCV. NAFLD and NASH denotefatty infiltration of the liver that are not due to excessive alcohol, andare related instead to insulin resistance, type 2 diabetes, obesity, and themetabolic syndrome. These abnormalities are now receiving considerableattention not only because they may progress to liver cirrhosis, but also asadditional risk factors for cardiovascular disease. The best currentestimates suggest that in the general population NAFLD can be found in 3% to24% of adults.
Despite improved prevention, diagnosis, and treatment, the overall costsof liver disease remain very high because of an increase prevalence ofselected conditions, and the common progression to a chronic state possiblyleading to life-threatening complications.
About EASL
The European Association for the Study of the Liver (EASL) aims topromote investigation into liver disease and improve the treatments thatcurrently exist for these conditions. The association, through its annualmeetings, seeks to inform and educate both the scientific community as wellas society in general about the increasing occurrence of liver diseases alongwith the im
