Alcohol-Associated Liver Disease (ALD)

Alcohol-associated liver disease represents a major cause of chronic liver morbidity and mortality worldwide. It encompasses a spectrum ranging from simple steatosis to alcoholic hepatitis, progressive fibrosis, cirrhosis, and hepatocellular carcinoma. The pathogenesis of ALD involves complex interactions between excessive alcohol intake, oxidative stress, immune activation, gut barrier dysfunction, and genetic susceptibility. Recent research highlights the role of gut microbiota alterations and systemic inflammation in disease progression. Clinical presentation varies widely, from asymptomatic biochemical abnormalities to life-threatening acute alcoholic hepatitis. Early identification of high-risk individuals and timely intervention remain critical challenges. Management strategies emphasize alcohol abstinence, nutritional support, treatment of complications, and pharmacologic therapies in selected patients. Emerging biomarkers and non-invasive fibrosis assessment tools are improving disease staging and prognosis. This topic addresses advances in understanding disease mechanisms, evolving therapeutic approaches, and multidisciplinary strategies to improve outcomes in patients with alcohol-associated liver disease.