Scope of the problem: Alcohol abuse is a leading cause of morbidity and mortality worldwide1'2. Estimates suggest that about 18 million Americans abuse alcohol3 and that Alcoholic Liver Disease (ALD) affects over 10 million people in the United States4. Alcohol abuse's deleterious effects on the liver lead to three pathologically distinct entities: Alcoholic Fatty Liver, Alcoholic Steatohepatitis (ASH) and cirrhosis. Fatty liver occurs in up to 90% of alcoholics, of whom 10-35% have alcoholic hepatitis on liver biopsy5'6. The spectrum of alcoholic hepatitis can range from mild transaminase elevation as the only indication of disease, to severe liver dysfunction with complications such as jaundice, hepatic encephalopathy, ascites, esophageal varices, coagulopathy and coma. In severe cases, reported mortality ranges from 30 to 60%6. Progression to cirrhosis occurs at a variable rate and different studies have reported this outcome in 10 to 30% of affected subjects with ALD. Alcoholic cirrhosis remains among the most common indications for liver transplantation worldwide7.
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