Changes in alcohol use following a diagnosis of alcohol-related liver disease: a clinical cohort study.

Authors

Anna Emilie Kann, Lone Galmstrup Madsen, Jonas Hedelund Rønn, Debbie Lindsay Shawcross, Nicola Kalk, Marianne Lerbæk Bergmann, Peter Jepsen, Gro Askgaard

Published in

JHEP reports : innovation in hepatology. Pages 101935. Jul 02, 2026. Epub Jul 02, 2026.

Abstract

Alcohol use is the key driver of progression in alcohol-related liver disease (ALD). We aimed to describe changes in alcohol use following a diagnosis of ALD.
From 2021-2025, we screened 299 consecutive patients newly diagnosed with ALD at Zealand University Hospital, Denmark. At baseline, we interviewed patients about their current and lifetime alcohol use and motivation to reduce it, and we measured the alcohol biomarker phosphatidylethanol (PEth). We followed patients' alcohol use for 90 days and assessed predictors of abstinence after 90 days. 1 drink equalled 12 grams of alcohol.
Of 104 newly diagnosed patients with ALD, 30% had decompensated cirrhosis, the median age was 64 years, and 76% were men. Patients reported escalating use of alcohol in the 30 years leading up to diagnosis of ALD, with 76% drinking ≥20 drinks/week the last five years before diagnosis. Shortly after the ALD diagnosis, only 24% reported drinking ≥20 drinks/week, and 56% reported abstinence, whereas abstinence occurred for 37% based on the alcohol biomarker. About 60% of patients expressed high motivation for and high confidence in obtaining abstinence at diagnosis. The risk of relapse after 90 days of follow-up was 37% (95%CI, 26-52) in patients abstaining at baseline. Predictors of abstinence at 90 days were motivation to change, confidence in change, and low PEth value at baseline, whereas severity of liver disease and AUDIT were not significantly associated.
A diagnosis of ALD leads to a profound change in alcohol use, with around half of patients reporting abstinence after years of escalating use. Unfortunately, early relapse is common.
Our study demonstrated a window for behavioural change shortly after a diagnosis of ALD, during which many patients reduced alcohol use or achieved abstinence. These findings highlighted early change but also a considerable risk of relapse after diagnosis. The results supported integrating structured alcohol use disorder treatment into liver clinics, although the observational design, self-reported alcohol use, and small sample size should be considered.

PMID:
42392507
Bibliographic data and abstract were imported from PubMed on 03 Jul 2026.

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