Epidemiology of Alcohol-Associated Hepatitis: A Systematic Review of Population-Based Studies.

Authors

Jakub Gazda, Tomas Koky, Aleksandra Robinska, Na Bo, Einar Stefan Bjornsson, Sylvia Drazilova, Martin Janicko, Luis Antonio Díaz, Fisher Rhoads, Peter Jarcuska, Juan Pablo Arab

Published in

Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association. Jul 11, 2026. Epub Jul 11, 2026.

Abstract

Alcohol-associated hepatitis (AH) is an acute and severe manifestation of alcohol-related liver injury that can occur at any stage of fibrosis. Despite its high mortality, reliable epidemiological data on AH remain limited. We conducted a systematic review to synthesize available population-based estimates of AH annual incidence and point prevalence from 2000 to 2025.
A comprehensive literature search of MEDLINE (PubMed), Scopus, and the Cochrane Library was performed. Eligible studies reporting population-based rates of AH were included. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data.
Eleven population-based studies from seven countries were included. Reported annual incidence rates of AH ranged from 1.02 per 100,000 inhabitants in Iceland to 98.5 per 100,000 inhabitants in the United States, with a median incidence rate of 6.8 cases per 100,000 inhabitants (IQR 4.2-19). Among the nine studies reporting at least two estimates over time, seven demonstrated an increasing incidence rate, whereas two reported a decrease. A pre-pandemic sensitivity analysis excluding studies affected by the COVID-19 pandemic showed a similar pattern, with incidence rates increasing in five of the seven studies. Two studies reported a surge in incidence during the COVID-19 pandemic, while one of them extended follow-up beyond the pandemic period and observed a gradual return toward pre-pandemic levels. No studies reported prevalence data.
The global burden of AH remains poorly characterized. Existing population-based estimates are highly heterogeneous, reflecting differences in case definitions as well as probable true epidemiological variation across countries, and collectively suggest an increasing trend over the past 25 years. These findings underscore the urgent need for prospective studies employing standardized and harmonized methodologies to more accurately define the burden of this condition.

PMID:
42435889
Bibliographic data and abstract were imported from PubMed on 12 Jul 2026.

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