Alcoholic hepatitis. Recent advances in pathogenesis and therapy.

Although the pathogenesis of alcoholic hepatitis is not fully understood, significant progress has been achieved in recent years. The role of the immune system in initiating and perpetuating the injury is being defined. Abstinence from alcohol is probably the most effective treatment. Nutritional support has not had a consistently beneficial effect on survival rates. There is renewed interest in the use of corticosteroids in patients with severe disease. Orthotopic liver transplantation is appropriate for some patients with end-stage liver disease.