Will the increased prevalence of nonalcoholic steatohepatitis (NASH) in the age of better hepatitis C virus therapy make NASH the deadlier disease?

摘要

Approximately one-third of the US population is presumed to have nonalcoholic fatty liver disease (NAFLD), with a similar prevalence reported in other parts of the world. Liver-related morbidity stems almost entirely from those individuals with nonalcoholic steatohepatitis (NASH). The prevalence of NASH in the United States is estimated to be 3%-5%, or roughly 9 million to 15 million persons, of whom up to 20% will develop cirrhosis. As a comparator, hepatitis C virus (HCV) infection, which is the leading indication for liver transplantation, had a prevalence of 1.6% between 1999 and 2002, representing approximately 4.1 million Americans. Although the incidence of HCV has plateaued and will possibly decrease over the long term, the incidence of NAFLD is on the rise. Thus, it is not surprising that NASH is predicted to surpass HCV as an indication for liver transplantation in the next 20 years.