Premium
B ermuda Triangle for the liver: Alcohol, obesity, and viral hepatitis
Author(s) -
Zakhari Samir
Publication year - 2013
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12207
Subject(s) - medicine , liver disease , hepatitis b , hepatitis b virus , hepatitis c , hepatitis c virus , liver transplantation , obesity , viral hepatitis , immunology , virology , disease , hepatitis , virus , transplantation
Despite major progress in understanding and managing liver disease in the past 30 years, it is now among the top 10 most common causes of death globally. Several risk factors, such as genetics, diabetes, obesity, excessive alcohol consumption, viral infection, gender, immune dysfunction, and medications, acting individually or in concert, are known to precipitate liver damage. Viral hepatitis, excessive alcohol consumption, and obesity are the major factors causing liver injury. Estimated numbers of hepatitis B virus (HBV) and hepatitis C virus ( HCV )‐infected subjects worldwide are staggering (370 and 175 million, respectively), and of the 40 million known human immunodeficiency virus positive subjects, 4 and 5 million are coinfected with HBV and HCV , respectively. Alcohol and HCV are the leading causes of end‐stage liver disease worldwide and the most common indication for liver transplantation in the U nited S tates and Europe. In addition, the global obesity epidemic that affects up to 40 million Americans, and 396 million worldwide, is accompanied by an alarming incidence of end‐stage liver disease, a condition exacerbated by alcohol. This article focuses on the interactions between alcohol, viral hepatitis, and obesity (euphemistically described here as the B ermuda Triangle of liver disease), and discusses common mechanisms and synergy.