National Liver Health Plan: The 2032 Challenge.

Spanish Association for the Study of the Liver (AEEH) has presented its proposal for the National Liver Health Plan: Challenge 2032, a document with which it seeks to respond to the escalation of chronic liver pathologies. And this is what One in five Spaniards is at risk of developing liver disease and pathologies related to this organ already represent the third cause of premature death in Spain. They are also the second leading cause of disability after cardiovascular disease, “and the problem is that they come after irresistible uptrendbecause they are linked to unhealthy habits and lifestyles that are becoming increasingly common in our society, such as alcohol abuse, unhealthy diet or sedentary lifestyle,” explained AEEH President Dr. Manuel Romero (HU Virgen del Rocío).

This expert took part in the round table, which was also attended by Dr. Rocío Aller, Secretary of AEEH (HU Valladolid); Dr. José Luis Calleja (HU Puerta de Hierro); Dr. Javier Crespo. (HU Marqués de Valdecilla) and the President of FNETH (National Federation of Liver Transplantation) Eva Pérez Bech.

Specialists are of particular concern increasing prevalence of a disease known as “fatty liver”

(metabolic hepatic steatosis) associated with obesity and type 2 diabetes, e.g. liver diseases associated with alcohol consumption. The former is already the most common liver pathology in our country, as it is estimated to affect three out of every ten Spaniards, and both have replaced viral hepatitis as the main cause of liver cirrhosis, liver cancer and indication for transplantation, with features In addition, the incidence These two pathologies not only grow, but also occur at an increasingly younger age.

Prevention and early detection

The Plan focuses on prevention and early detection. First, it establishes the fundamental goal of influencing lifestyle and behavioral changes that are driving the rise in non-viral liver diseases. In particular, it is considered necessary to take alcohol consumption very seriously at an increasingly younger age, since it is already the first cause of the development of liver cirrhosis and the need for liver transplantation, in addition to being directly or indirectly behind it. , more than 50 percent of liver cancer cases. Likewise, it is considered necessary to take decisive measures to prevent obesity, which is the cause of the progression of fatty liver, which already affects more than 10 million Spaniards, of whom almost two million suffer from inflammation of the liver (steatohepatitis), and of these, 400,0000 have already had would be cirrhosis of the liver. “Most liver diseases are preventable and to do this we must increase the knowledge of the population, and especially young people, about the factors that compromise liver health, the problems they are exposed to and how to avoid them. them,” said Dr. Rocío Aller.

Towards early detection“The great difficulty is that liver pathologies are silent diseases: their symptoms are non-specific and do not appear until the liver has experienced significant damage,” said Dr. José Luis Calleja, emphasizing that their early diagnosis “is very important develop interventions that will completely change the prognosis of the disease.” For example, changing diet and targeted physical activity in patients with metabolic liver disease can reverse the disease in more than 80% of cases. Likewise, stopping alcohol consumption can counteract the effects of liver disease in most cases and significantly improve prognosis. “And the Plan emphasizes the need to screen for liver disease in all people who have risk factors such as diabetes, obesity or alcohol abuse!”

Viral hepatitis: there is still a way to go

Although fatty liver disease and alcohol-related liver disease are pathologies that are clearly on the rise, the Plan does not forget viral hepatitis, which he considers an “unsolved problem”, especially in the case of hepatitis C, where Spain is already the country in the world that has treated and cured the most patients per million population and is close to making history if it achieves elimination. it is a chronic viral infection. To achieve this goal, it is critical to improve diagnosis and treatment of vulnerable populations (who account for the majority of infections) and, equally, to promote opportunistic screening in the general population. “Testing for hepatitis C is extremely easy and cheap, which is why we believe everyone should get tested at least once in their life,” said Dr. Javier Crespo.

Finally, the Plan also addresses so-called minority liver diseases (classified into three groups: autoimmune, toxic-metabolic and vascular-hepatic), highlighting the importance that precision medicine must have in better characterizing them and thus providing better care. and clinical practice with patients.

Overall, to improve the approach to all these liver pathologies, the Plan identifies a total of fifteen strategic goals and 53 action areas, classified into three main action areas: prevention, diagnosis, treatment and follow-up. More than 60 experts worked on this document with collaboration from AbbVie and AstraZeneca and technical support from Ernest & Young. In addition, as the FNETH President explained, patients were actively involved in the Plan.