Liver Diseases in Latin America: Current Status, Unmet Needs, and Opportunities for Improvement

Luis Antonio Díaz; Gustavo Ayares; Jorge Arnold; Francisco Idalsoaga; Oscar Corsi; Marco Arrese; Juan Pablo Arab

doi:10.1007/s11938-022-00382-1

Liver Diseases in Latin America: Current Status, Unmet Needs, and Opportunities for Improvement

Curr Treat Options Gastroenterol. 2022;20(3):261-278. doi: 10.1007/s11938-022-00382-1. Epub 2022 Jun 16.

Authors

Luis Antonio Díaz¹, Gustavo Ayares¹, Jorge Arnold¹, Francisco Idalsoaga¹, Oscar Corsi¹, Marco Arrese^{1

2}, Juan Pablo Arab^{1

3

4}

Affiliations

¹ Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile.
² Centro de Envejecimiento Y Regeneración (CARE), Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile.
³ Division of Gastroenterology, Department of Medicine, Schulich School of Medicine, Western University & London Health Sciences Centre, London, ON Canada.
⁴ Department of Epidemiology and Biostatistics, Schulich School of Medicine, Western University, London, ON Canada.

Abstract

Purpose of review: To assess the current challenges regarding liver diseases, including the burden of disease, access to care, screening, and treatment needs in Latin America.

Recent findings: Latin America is a region with a rich multicultural heritage and important socioeconomic differences. The burden of liver diseases is high and mainly determined by a high level of alcohol intake and the surge of risk factors associated with NAFLD (i.e., sedentary lifestyles, broader access to highly processed foods, obesity, and type 2 diabetes mellitus). Hepatotropic viruses also play a role in the development of chronic liver diseases, although their comparative frequency has been decreasing over the last decades. There are important disparities in access to screening and treatment for liver diseases in Latin America, which are reflected in low access to critical treatments such as direct-acting antiviral agents and drugs to treat hepatocellular carcinoma. Also, important barriers to liver transplantation are present in multiple countries, including a low deceased donors' rate and a lack of availability in several countries (especially in Central America). Our region also has disadvantages in research and education in liver diseases, which limits regional academic development and improvement in quality of care of liver diseases.

Summary: In order to tackle an increasing health burden due to liver diseases, Latin America urgently needs tailored interventions aiming to control the main risk factors for these disorders through the establishment of effective public health policies. Also, development of liver transplantation programs and improvement of medical education and research capabilities as well as extensive collaboration between all stakeholders are keys to address the liver disease agenda in the region.

Keywords: ALD; Alcohol; Alcohol use disorders; Alcohol-associated hepatitis; Cirrhosis; Fatty liver disease; Public policy; Steatosis.

Publication types

Review