Non-alcoholic Steatohepatitis Diagnosis and Treatment - Current Concepts

NAFLD (Non-alcoholic fatty liver disease) is a condition of high importance due to its increased prevalence, estimated at 24% of the global population, and its potential progression to advanced liver disease, cirrhosis, and hepatocellular carcinoma. One-quarter of NAFLD patients have NASH (non-alcoholic steatohepatitis), which is histologically described as liver steatosis, inflammation, fibrosis, hepatocyte injury, and death. Metabolic disruptions, such as obesity, diabetes, and dyslipidemia, are considered to have a great impact on the development of NASH. Patients may have NAFLD for a long time before progressing into NASH, which highlights the necessity of periodic imaging and biochemical evaluation of the liver, and also presents an optimal window of therapeutic intervention. The challenge in developing treatment for NASH stems from the slow progression of the disease and the reliance on sequential biopsies as the diagnostic and staging tools. Several non-invasive tests have been developed as potential future alternatives to the current invasive gold standard. This review aims to assess the current available methods of diagnosis and treatment targeting inflammation.