Gustot, T;
Fernandez, J;
Szabo, G;
Albillos, A;
Louvet, A;
Jalan, R;
Moreau, R;
(2017)
Sepsis in Alcohol-related Liver Disease.
Journal of Hepatology
, 67
(5)
pp. 1031-1050.
10.1016/j.jhep.2017.06.013.
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Abstract
Alcohol-related liver disease (ALD) remains the most important cause of death due to alcohol. Infections, particularly bacterial infections, are one of the most frequent and severe complications of advanced ALD, as alcoholic cirrhosis and severe alcoholic hepatitis (sAH). The specific mechanisms responsible of this altered host defence become to be deciphered. The aim of the present work is to review the current knowledge about infectious complications in ALD and the pathophysiological mechanisms, distinguishing the role of alcohol consumption and the contribution of different forms of ALD. To date, corticosteroids are the sole proven effective treatment in sAH but its impact on the occurrence of infections remains controversial. The combination of an altered host defence and corticosteroids treatment in sAH has been suggested as cause of the emergence of opportunistic fungal and viral infections. High level of suspicion with systematic screening and prompt, adequate treatment are warranted to improve outcome of those patients. Prophylactic or preemptive strategies in this high-risk population might be a preferable option due to the high short-term mortality rate despite adequate therapies but should be assessed in well-designed trials before clinical implementation.
| Type: | Article |
|---|---|
| Title: | Sepsis in Alcohol-related Liver Disease |
| Location: | Netherlands |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.jhep.2017.06.013 |
| Publisher version: | http://doi.org/10.1016/j.jhep.2017.06.013 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Alcoholic cirrhosis, bacteria and fungus, corticosteroids, immune dysfunction, infection, severe alcoholic hepatitis |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inst for Liver and Digestive Hlth |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1563621 |
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