Evaluating for liver fibrosis in patients with alcohol-associated steatotic liver disease

This figure summarizes an approach to evaluating for advanced fibrosis and cirrhosis in patients with alcohol-associated liver disease who do not have signs of portal hypertension (eg, ascites) and do not have cirrhosis on imaging (eg, transabdominal ultrasound). FIB-4 index and liver stiffness measurements inform management; however, cutoff values for diagnosing fibrosis vary among studies and underlying liver disease^[1,2]. This algorithm is intended for use in conjunction with UpToDate content on the clinical features and diagnosis of alcohol-associated liver disease. Further management of patients with cirrhosis includes screening for and preventing cirrhosis-related complications (eg, variceal bleeding, hepatocellular carcinoma).