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World J Gastroenterol. Oct 28, 2022; 28(40): 5818-5826
Published online Oct 28, 2022. doi: 10.3748/wjg.v28.i40.5818
Management of liver diseases: Current perspectives
Gautam Ray
Gautam Ray, Gastroenterology Unit, Department of Medicine, B.R.Singh (Railway) Hospital, Kolkata 700014, West Bengal, India
Author contributions: Ray G conceptualized the topic, collected data, drafted, edited and approved the final manuscript.
Conflict-of-interest statement: The author reports no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Gautam Ray, DNB, MD, Academic Research, Chief Doctor, Doctor, Teacher, Gastroenterology Unit, Department of Medicine, B.R.Singh (Railway) Hospital, Parikshit Roy Lane, Near Sealdah Bus Stop, Beliaghata, Kolkata 700014, West Bengal, India. gautam1910@yahoo.com
Received: July 10, 2022
Peer-review started: July 10, 2022
First decision: July 31, 2022
Revised: August 4, 2022
Accepted: September 21, 2022
Article in press: September 21, 2022
Published online: October 28, 2022
Processing time: 109 Days and 22.3 Hours
Abstract

There is increasing incidence and prevalence of acute and chronic liver diseases (CLDs) all over the world which influence the quality of life and can give rise to life threatening complications. The burden of advanced liver disease due to hepatitis B has been controlled by antivirals but its eradication is difficult soon. Highly effective directly acting antiviral therapy has reduced the burden of hepatitis C but is partially offset by increasing IV drug abuse. Non-alcoholic fatty liver disease pandemic is on and there is recent alarming increase in alcohol related liver disease, both of which have no drug cure apart from control of the risk factors. Genetic factors have been identified in progression of all forms of CLD. Due to better management of complications of CLD, the life span of patients have increased spiking the number of hepatocellular carcinoma (HCC) and patients needing liver transplantation (LT). The present severe acute respiratory syndrome coronavirus pandemic has affected the outcome CLD including LT in addition to causing acute hepatitis. Better diagnostics and therapeutics are available for liver fibrosis, portal hypertension, HCC and post LT management and many drugs are under trial. The present review summarises the current scenario of the epidemiology and the advances in diagnosis and treatment of liver diseases including their complications like portal hypertension, HCC and LT.

Keywords: Chronic liver disease; Genes; Biomarkers; Therapy; Hepatocellular carcinoma; Liver transplantation; Recent advances

Core Tip: The incidence and prevalence of liver disease is rising all over the world. Hepatitis B is difficult to eradicate and the benefit of directly acting antiviral therapy for hepatitis C is partially offset by increasing IV drug abuse. Non-alcoholic fatty liver disease pandemic is on and alcohol related liver disease is rising alarmingly, both having no drug cure. Due to better management of complications, patients of chronic liver disease are living longer spiking the number of hepatocellular carcinoma (HCC) and patients needing liver transplantation (LT). Better diagnostics and therapeutics are available for fibrosis, portal hypertension, HCC and post LT management which are discussed.