Identification of Patients with Advanced Fibrosis Due to Nonalcoholic Fatty Liver Disease: Considerations for Best Practice (original) (raw)

Authors

Salvador Augustin Liver Unit Hospital Univ. Vall d‘Hebron, Vall d’Hebron Research Inst., Univ. Autònoma de Barcelona, Spain
Aijaz Ahmed Div. of Gastroenterol. and Hepatol, Stanford Univ. School of Medicine, Stanford, California, USA
Naim Alkhouri Texas Liver Institute, Univ. Texas Health Science Center at San Antonio, San Antonio, Texas, USA
Ali Canbay Dept. of Gastroenterol, Hepatol. and Infectious Dis, Univ. Magdeburg, Magdeburg, Germany
Lynsey Corless Hull University Teaching Hospitals NHS Trust, Univ. of Hull, Hull, UK
Atsushi Nakajima Dept. of Gastroenterol and Hepatol, Yokohama City Univ. Graduate School of Medicine, Yokohama, Japan
Takeshi Okanoue Dept. Gastroenterol and Hepatology, Saiseikai Suita Hospital, Suita, Japan
Salvatore Petta Section of Gastroenterol and Hepatol, PROMISE, Univ. Palermo, Palermo, Italy
Vlad Ratziu Institute for Cardiometabolism and Nutrition, Sorbonne Université, Hospital Pitié Salpêtrière, Paris, France
Emmanuel A Tsochatzis UCL Institute for Liver and Digestive Health, Royal Free Hospital, London, UK
Vincent Wai-Sun Wong Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong; State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong
Manuel Romero-Gómez UCM Digestive Diseases, Virgen del Rocío University Hospital, University of Seville, Seville, Spain

DOI:

Keywords:

advanced fibrosis, best practice, identification, NAFLD, NASH

Abstract

Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) prevalence has increased in the past two decades, resulting in a significant but under-recognised public health burden. This impacts the prevalence of advanced fibrosis, end-stage liver disease and associated extrahepatic manifestations. To understand the challenges in recognising patients with advanced fibrosis due to NASH and develop a standardised approach to screen these patients, the authors of this document provided their opinions and expertise from practice and published evidence to identify key challenges and current approaches for diagnosing NASH. The severity of liver fibrosis due to NASH is the main indicator of associated morbidity and mortality outcomes. Therefore, identifying patients with, or at risk of, advanced fibrosis due to NASH and linking them to appropriate care is critical. This can be challenging due to a lack of awareness of NASH among healthcare professionals and a lack of standardised protocols for identifying patients. Simple noninvasive tests may provide an opportunity to facilitate early identification of these patients. This article proposes a simple, universally applicable diagnostic algorithm for use in clinical practice, that includes sequential use of noninvasive tests, ideally a biological marker and an imaging technique, which may help to facilitate early diagnosis of these patients. In the opinion of the authors, early detection of advanced fibrosis is fundamental in the efforts to halt the progression of NASH and diagnostic algorithms may facilitate pre-emptive interventions to curtail the disease.

How to Cite

Augustin S, Ahmed A, Alkhouri N, Canbay A, Corless L, Nakajima A, Okanoue T, Petta S, Ratziu V, Tsochatzis EA, Wong VW-S, Romero-Gómez M. Identification of Patients with Advanced Fibrosis Due to Nonalcoholic Fatty Liver Disease: Considerations for Best Practice. JGLD [Internet]. 2020 Jun. 3 [cited 2026 Feb. 14];29(2):235-4. Available from: https://jgld.ro/jgld/index.php/jgld/article/view/775