NASH: evaluation and treatment

Published on August 29, 2019   50 min

A selection of talks on Clinical Practice

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Hello, my name is Dr. Arun Sanyal. I'm a Professor of Medicine, Physiology and Molecular Pathology in the division of Gastroenterology and Hepatology at Virginia Commonwealth University, School of Medicine. Today, I will talk about "NASH and its Evaluation and Treatment".
Here are my conflicts of interest.
So a good place to start this discussion is to talk about the global burden of NASH. As you can see from this map of the world, there is a high prevalence of nonalcoholic fatty liver disease or NAFLD throughout the world. Approximately a quarter of the population in many different countries has excess fat in their liver. The prevalence is very high in North America but probably highest in the Middle East and South America. Whereas in Africa the prevalence is a little bit lower. The reason we worry about this is because cirrhosis-related outcome in people with nonalcoholic fatty liver disease is increasing, and dynamic models of the disease indicate that by 2030 the number of people living with cirrhosis will almost triple. The number of people with decompensated cirrhosis, due to fatty liver disease, will rise from about a hundred thousand currently to about 300,000. Remember that liver transplant is an option only when an organ is available, and many patients with NASH may not even qualify for a liver transplant due to comorbidities which we'll talk about in a minute. So this is a major public health problem for which we need solutions.