Diagnosis and therapy of alcoholic liver disease

Josh Levitsky, Mark E. Mailliard

Research output: Contribution to journalReview articlepeer-review

97 Scopus citations


Alcoholic liver disease (ALD) presents considerable challenges to clinicians. Screening for alcohol abuse and alcoholism should be routine and repeated annually with close attention to signs and symptoms of liver disease. In patients with evidence of liver dysfunction or injury, consideration should be given to performance of liver biopsy for diagnosis and prognosis and prior to initiation of medication with the potential for significant side effects. Therapy depends on the spectrum of pathological liver injury: alcoholic fatty liver, alcoholic hepatitis, and cirrhosis. Abstention is the foundation of therapy for an alcohol problem. Alcoholic fatty liver should improve with abstention, but the similarity to the pathogenesis of nonalcoholic fatty liver and potential for progressive injury merits consideration of lipotropic agents. The continuing mortality, poor acceptance of corticosteroids, and identification of tumor necrosis factor-alpha (TNF-α) as an integral component has led to studies of pentoxifylline and, recently, anti-TNF antibody to neutralize cytokines in the therapy of severe alcoholic hepatitis. Antioxidant therapy of alcoholic cirrhosis has significant promise but will require large clinical trials.

Original languageEnglish (US)
Pages (from-to)233-247
Number of pages15
JournalSeminars in liver disease
Issue number3
StatePublished - Aug 2004


  • Alcoholic
  • Antibodies
  • Corticosteroids
  • Liver disease
  • Monoclonal
  • Tumor necrosis factor-alpha

ASJC Scopus subject areas

  • Hepatology


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