Alcohol-related Liver Disease Clinical Practice Guidelines (AFEF, 2022)

French Association for the Study of the Liver

These are some of the highlights of the guidelines without analysis or commentary. For more information, go directly to the guidelines by clicking the link in the reference.

June 01, 2022

Guidelines for the management of alcohol-related liver disease were published in April 2022 by the French Association for the Study of the Liver (AFEF) in Liver International.[1]

Use the AUDIT-C questionnaire in general practice and specialist consultation for the detection of excessive alcohol consumption.

Counsel patients with cirrhosis and/or hepatocellular carcinoma to completely and permanently stop all alcohol consumption to limit the risk of excess mortality.

Treat symptomatic alcohol withdrawal with benzodiazepines until symptoms disappear.

Consider pharmacological treatment for promoting the maintenance of alcohol consumption targets (abstinence or reduced consumption) in dependent patients.

Non-invasive assessment of liver fibrosis is recommended in all patients with alcohol-related liver disease.

A liver biopsy is recommended to confirm the clinical suspicion of alcoholic hepatitis in patients who are potential candidates for specific treatment.

In the absence of liver biopsy, use the National Institute on Alcohol Abuse and Alcoholism classification to offer treatment only to patients with probable alcoholic hepatitis.

Use the following criteria to identify people with advanced alcohol-related liver disease in the general population: aged ≥ 40–45 years with an AUDIT score predictive of hazardous consumption and/or consumption of ≥ 14 standard drinks/week.


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