A PUBLIC HEALTH INITIATIVE FROM THE AMERICAN LIVER FOUNDATION DEMONSTRATES THE FEASIBILITY OF A SCREENING PROGRAM FOR FATTY LIVER DISEASE

Document Type

Conference Proceeding

Publication Date

10-1-2023

Publication Title

Hepatology

Abstract

Background: Nonalcoholic fatty liver disease (NAFLD) prevalence is estimated to be 80-100 million in the US. NAFLD is highly under-diagnosed due to inadequate screening programs, and as a result can progress to non-alcoholic steatohepatitis (NASH), liver cirrhosis, liver cancer, the need for liver transplantation, and death. NAFLD is often asymptomatic and disproportionately affects disadvantaged communities. Although early detection allows for timely intervention to improve disease course, screening for fatty liver diseases is not offered as part of routine medical care outside of hepatology clinics. To address this gap, the American Liver Foundation (ALF) launched a pilot NAFLD Screening Program for high-risk individual’s in Texas.

Methods: ALF consulted with public health professionals in Houston to identify a non-profit community-based clinic (Fundación Latinoamericana De Acción Social) providing essential healthcare services to those with limited access. The clinic completed steps necessary to become a screening site to conduct LIVERFASt tests, a blood test that measures 10 biomarkers for liver health (Figure 1). Clinic staff were trained, screening tests were performed on at-risk individual’s (Figure 1), and results were analyzed for evidence of steatosis and fibrosis.

Results: A total of 448 individual’s participated in the NAFLD screening program (62% females, mean age = 43 y), among whom 63% had a steatosis score of S1 or higher, with moderate to severe steatosis (S2-S3) in 32%. Importantly, most participants with S2-S3 had little evidence of fibrosis, signaling an opportunity to potentially halt or reverse disease. Participants with scores ≥S1 were given educational resources on NAFLD and healthy lifestyle choices and linked to healthcare providers for follow-up care. After the pilot program concluded in 2021, the established processes were sustained to continue screening at the clinic. Based on lessons learned, ALF has expanded screening through ALF’s National Public Health Campaign, Think Liver Think Life, in Federally Qualified Health Centers and Community Clinics in 21 states.

Conclusion: NAFLD/NASH is an emerging under-diagnosed healthcare crisis, and our pilot program demonstrates the feasibility of widespread screening in high-risk individual’s. The ALF plans to expand the Think Liver Think Life campaign to all 50 states within 5 years, with the goal to improve education, early diagnosis, and access to care for people with liver disease.

Volume

78

First Page

S753

Last Page

S754

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