Clinical practice guidelines on alcohol-related liver disease (AFEF, 2022)

Recommendations for the management of alcohol-related liver diseases were published in April 2022 by the French Association for the Study of the Liver (AFEF) in international liver.[1]

Use the AUDIT-C questionnaire in general medicine and in specialized consultations for the detection of excessive alcohol consumption.

Advise patients with cirrhosis and/or hepatocellular carcinoma to completely and permanently stop all alcohol consumption in order to limit the risk of excess mortality.

Treat symptomatic alcohol withdrawal with benzodiazepines until symptoms resolve.

Consider pharmacological treatment to help maintain alcohol consumption goals (abstinence or reduced consumption) in addicted patients.

Noninvasive assessment of liver fibrosis is recommended in all patients with alcohol-related liver disease.

Liver biopsy is recommended to confirm the clinical suspicion of alcoholic hepatitis in patients who are potential candidates for specific treatment.

In the absence of a liver biopsy, use the National Institute on Alcohol Abuse and Alcoholism classification to offer treatment only to patients with probable alcoholic hepatitis.

Use the following criteria to identify people with advanced alcohol-related liver disease in the general population: aged ≥ 40 to 45 years with an AUDIT score predictive of hazardous drinking and/or drinking ≥ 14 standard drinks/week.

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