Alcohol‐Related Liver Disease in Latin America: Local Solutions for a Global Problem

Díaz, Luis Antonio; Roblero, Juan Pablo; Bataller, R.; Arab, Juan Pablo

doi:10.1002/cld.1025

Cited by 16 publications

(10 citation statements)

References 11 publications

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“…In addition, there are no specific public health policies on NAFLD in the Americas, which is similar to the situation of other world regions [98]. Thus, it is important to promote public health policies and raise awareness of the main risk factors for liver disease in Latin America [51,60].…”

Section: Unmet Needs In Liver Diseases and Future Perspectivesmentioning

confidence: 99%

“…Men have a higher prevalence of alcohol use disorder (AUD) than women (8% vs. 2%, respectively), a phenomenon that is similar to other regions [4,12]. In addition, low and lower-middleincome countries have the highest AUD prevalence, even with lesser alcohol consumption than countries with higher income [59,60].…”

Section: Alcohol Consumptionmentioning

confidence: 99%

“…Interestingly, higher mortality of alcohol-related health consequences has been described in low-income countries, despite a lower alcohol consumption than countries with a higher income [97]. Therefore, it is especially relevant to implement robust and tailored measures to address alcohol misuse and its consequences [18,60]. In addition, there are no specific public health policies on NAFLD in the Americas, which is similar to the situation of other world regions [98].…”

Section: Unmet Needs In Liver Diseases and Future Perspectivesmentioning

confidence: 99%

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Liver Diseases in Latin America: Current Status, Unmet Needs, and Opportunities for Improvement

Díaz

Ayares

Arnold

et al. 2022

Curr Treat Options Gastro

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Purpose of review To assess the current challenges regarding liver diseases, including the burden of disease, access to care, screening, and treatment needs in Latin America. Recent findings Latin America is a region with a rich multicultural heritage and important socioeconomic differences. The burden of liver diseases is high and mainly determined by a high level of alcohol intake and the surge of risk factors associated with NAFLD (i.e., sedentary lifestyles, broader access to highly processed foods, obesity, and type 2 diabetes mellitus). Hepatotropic viruses also play a role in the development of chronic liver diseases, although their comparative frequency has been decreasing over the last decades. There are important disparities in access to screening and treatment for liver diseases in Latin America, which are reflected in low accessLiver (E Tapper, Section Editor) to critical treatments such as direct-acting antiviral agents and drugs to treat hepatocellular carcinoma. Also, important barriers to liver transplantation are present in multiple countries, including a low deceased donors' rate and a lack of availability in several countries (especially in Central America). Our region also has disadvantages in research and education in liver diseases, which limits regional academic development and improvement in quality of care of liver diseases. Summary In order to tackle an increasing health burden due to liver diseases, Latin America urgently needs tailored interventions aiming to control the main risk factors for these disorders through the establishment of effective public health policies. Also, development of liver transplantation programs and improvement of medical education and research capabilities as well as extensive collaboration between all stakeholders are keys to address the liver disease agenda in the region. AbbreviationsACLF Acute-on-chronic liver failure ALD Alcohol-associated liver disease ALF Acute liver failure AUD Alcohol use disorder DALYs Disability-adjusted life-years DILI Drug-induced liver injury GDP Gross domestic product HBV Hepatitis B virus HCV Hepatitis C virus HDV Hepatitis delta virus HCC Hepatocellular carcinoma LT Liver transplantation MAFLD Metabolic dysfunction-associated fatty liver disease NAFLD Non-alcoholic fatty liver disease NASH Non-alcoholic steatohepatitis PHP Public health policies PNPLA3 Patatin-like phospholipase domain-containing 3 US United States USD United States Dollars WHO World Health Organization * Updated to 2019 + Updated to 2020 Country Population in 2019 GDP + Gini index* Life expectancy from birth (years)* Deceased donors' rate* DDLT rate* LDLT rate* Argentina 44,938,712

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Section: Unmet Needs In Liver Diseases and Future Perspectivesmentioning

confidence: 99%

Section: Alcohol Consumptionmentioning

confidence: 99%

Section: Unmet Needs In Liver Diseases and Future Perspectivesmentioning

confidence: 99%

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Liver Diseases in Latin America: Current Status, Unmet Needs, and Opportunities for Improvement

Díaz

Ayares

Arnold

et al. 2022

Curr Treat Options Gastro

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“…29 This "paradox" has several potential mechanisms, including higher exposure to alcohol, frequent binge drinking episodes, consumption of formulations with higher alcohol content, beverages of poorer quality containing toxic substances (like formaldehyde and methanol), as well as harmful drinking patterns (e.g., having started drinking at a younger age and family history of consumption). [28][29][30][31][32] Other factors such as malnutrition, poorer education, health literacy, and access to healthcare facilities also influence this phenomenon. 33,34 Alarming evidence has demonstrated increased alcohol misuse in highrisk groups (including women) during the last years.…”

Section: Impact Of Harmful Alcohol Consumptionmentioning

confidence: 99%

Public Health Measures and Prevention of Alcohol-Associated Liver Disease

Ayares¹,

Idalsoaga²,

Arnold³

et al. 2022

Journal of Clinical and Experimental Hepatology

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“…There are important social, cultural, ethnic, and economic differences among Latin American countries. (20,21) Also, there is scarce information about Latin American PHP on alcohol consumption, and its impacts on health consequences are unknown. Hence, we aim to describe the different PHP on alcohol consumption in Latin American countries and establish a potential association with deaths due to ALD, alcohol use disorders (AUD), and alcohol-attributable deaths (AAD) due to road traffic injuries.…”

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confidence: 99%

Impact of Public Health Policies on Alcohol‐Associated Liver Disease in Latin America: An Ecological Multinational Study

et al. 2021

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BaCKgRoUND aND aIMS: Alcohol-associated liver disease (ALD) is the leading cause of liver-related mortality in Latin America, yet the impact of public health policies (PHP) on liver disease is unknown. We aimed to assess the association between alcohol PHP and deaths due to ALD in Latin American countries. appRoaCH aND ReSUltS:We performed an ecological multinational study including 20 countries in Latin America (628,466,088 inhabitants). We obtained country-level sociodemographic information from the World Bank Open Data source. Alcohol-related PHP data for countries were obtained from the World Health Organization Global Information System of Alcohol and Health. We constructed generalized linear models to assess the association between the number of PHP (in 2010) and health outcomes (in 2016). In Latin America, the prevalence of obesity was 27% and 26.1% among male and female populations, respectively. The estimated alcohol per capita consumption among the population at 15 years old or older was 6.8 L of pure alcohol (5.6 recorded and 1.2 unrecorded). The overall prevalence of alcohol use disorders (AUD) was 4.9%. ALD was the main cause of cirrhosis in 64.7% of male and 40.0% of female populations. A total of 19 (95%) countries have at least one alcoholrelated PHP on alcohol. The most frequent PHP were limiting drinking age (95%), tax regulations (90%), drunk-driving policies and countermeasures (90%), and government monitoring systems and community support (90%). A higher number of PHP was associated with a lower ALD mortality (PR, 0.76; 95% CI, 0.61-0.93; P = 0.009), lower AUD prevalence (PR, 0.80; 95% CI, 0.65-0.99; P = 0.045), and lower alcohol-attributable road traffic deaths (PR, 0.81; 95% CI, 0.65-1.00; P = 0.051). CoNClUSIoNS:Our study indicates that in Latin America, countries with higher number of PHP have lower mortality due to ALD, lower prevalence of AUD, and lower alcohol-attributable road traffic mortality. (Hepatology 2021;74:2478-2490.A lcohol consumption is an essential determinant of disease burden, with a significant impact on social life and the economy worldwide. (1) The burden of disease evaluated by the World Health Organization (WHO) and the Institute for Health and Metrics Evaluation estimates that 3.3 million deaths globally are related to alcohol consumption per year. (2,3) Hazardous alcohol intake produces a catastrophic impact

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Alcohol‐Related Liver Disease in Latin America: Local Solutions for a Global Problem

Abstract: http://aasldpubs.onlinelibrary.wiley.com/hub/journal/10.1002/(ISSN)2046-2484/video/16-5-reading-diaz a video presentation of this article http://aasldpubs.onlinelibrary.wiley.com/hub/journal/10.1002/(ISSN)2046-2484/video/16-5-interview-arab an interview with the author

Cited by 16 publications

References 11 publications

Liver Diseases in Latin America: Current Status, Unmet Needs, and Opportunities for Improvement

Liver Diseases in Latin America: Current Status, Unmet Needs, and Opportunities for Improvement

Public Health Measures and Prevention of Alcohol-Associated Liver Disease

Impact of Public Health Policies on Alcohol‐Associated Liver Disease in Latin America: An Ecological Multinational Study

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