Fatty liver highlights from International Liver Congress 2019

This year at the International Liver Congress, researchers presented data on advances in clinical therapeutics for nonalcoholic fatty liver disease and nonalcoholic steatohepatitis while also advocating for a focus on lifestyle intervention and needs for awareness.

For your convenience, Healio Gastroenterology and Liver Disease presents the following reports on rising NAFLD prevalence and mortality among individuals with HIV, rates among young adults, a new prediction tool, and exercise intervention.

Fatty liver prevalence, mortality rising in HIV population

As HIV reaches new levels of control and hepatitis C virus treatments give cures, providers must be aware that non-alcoholic fatty liver disease is on the rise in the population with HIV as it is in the general population.

“As you normalize these patients’ health by suppressing HIV and by curing HCV, they become healthier and that healthier profile in the U.S. is to become more obese and more diabetic. That is also true of HCV patients who don’t have HIV. As we cure them, a third of those patients if you rebiopsy them after HCV cure, they have underlying NAFLD,” Zobair M. Younossi, MD, chairman of the department of medicine at Inova Fairfax Hospital, Fairfax, Virginia, said during a press conference at the International Liver Congress. “In the future, we will probably treat these patients the same as anyone else whether they have HCV or NAFLD. You need to pay attention to this and treat them the same way.” Read more

1 in 5 young adults show signs of fatty liver; 1 in 40 have fibrosis

Young adults aged about 24 years showed a high prevalence of nonalcoholic fatty liver disease, with progression increasing with age even in a small birth cohort, according to new data presented during the International Liver Congress 2019.

“This is the only study to assess NAFLD prevalence in young adults using elastography. We found one in five had evidence of NAFLD; half had [steatosis grade 3 (S3)]. One in 40 in our cohort have evidence of fibrosis and this is in asymptomatic predominantly Caucasian participants with unselected general population birth cohort,” Kushala Abeysekera, MD, MBBS, BSc, from the University of Bristol, said during his presentation. “We’ve demonstrated that the prevalence of NAFLD in our birth cohort appears to have progressed from age 18 to 24 from 2.5% to 20.8%.” Read more

Fatty liver progresses quickly, increasing mortality risk

Patients with nonalcoholic fatty liver disease and nonalcoholic steatohepatitis showed progression to advanced liver disease within 10 years of diagnosis as well as increased risk for mortality, according to new data presented during the International Liver Congress 2019.

“NAFLD is not a benign condition,” Jerome Boursier, MD, PhD, from Angers University Hospital in Angers, France, said during a press conference. “We need to develop strategies for early identification of those patients at risk of liver-related complications and we need new effective treatments to avoid evolution to late stage of disease.” Read more

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NAFLD simulator offers teaching tools, risk prediction

A new, open-access simulator gives providers the tools to show natural progression of non-alcoholic fatty liver disease to their patients using personalized factors, according to an expert at the International Liver Congress.

“We developed an open-access interactive tool for patients and providers that can help them understand such long-term risks. Also, the other objective is to increase awareness of NASH and its consequences in patients,” Jagpreet Chhatwal, PhD, from Massachusetts General Hospital, said during his presentation. “We wanted to create something open access, for people by people, and we can continue to modify this model as we begin to understand the natural history of NAFLD better and as we progress with making more treatments available, they can be added later on.” Read more

Exercise intervention for NAFLD shows promise if adherence maintained

Patients with nonalcoholic fatty liver disease who underwent a 12-week aerobic exercise intervention showed significant improvements in hepatic and extrahepatic parameters after review of paired biopsies, according to a study presented at the International Liver Congress 2019.

“There are limited pharmacological interventions for the treatment of NAFLD, so lifestyle modifications are the first line of treatment,” Philip O’Gorman, from the University of Dublin in Ireland, said during his presentation. “However, many studies report that individuals with NAFLD struggle to meet or maintain weight loss guidelines, so this poses a problem for these individuals.” Read more