Sharp Rise in Advanced Alcohol-Related Liver Disease Despite Stable Drinking Rates: Changing Population Risks Highlighted by US Data

Highlights

• Advanced liver fibrosis among heavy drinkers in the US more than doubled from 1999 to 2020, despite stable average alcohol consumption.
• Increased prevalence of metabolic syndrome, aging, female sex, and poverty among heavy drinkers contributed to higher risk.
• Key marker: High Fibrosis-4 (FIB-4) scores, indicating a 25-fold increased risk for liver-related death, rose significantly.
• Findings urge targeted screening and intervention strategies for at-risk groups beyond alcohol quantity alone.

Clinical Background and Disease Burden