•This is the most common presentation of liver disease in North America (mild elevation of ALT or AST) occurring in 10% of the population, with three-quarters being due to MASLD (metabolic-dysfunction associated steatotic liver disease (related to obesity, diabetes, hyperlipidemia).
•Alcohol-related liver disease occurs in nearly 2% of the population.
•Viral hepatitis (most commonly chronic HBV or HCV) affects ~7% of the world’s population.
•Drug induced liver injury is common and can be due to prescribed, over-the-counter or illicit drugs and complimentary and alternative medications (herbals, supplements, etc)>
• Autoimmune hepatitis is an immune mediated liver injury
•Genetic causes include hereditary hemochromatosis (1:300 Caucasians), Alpha-1 Antitrypsin (A1AT) deficiency (1:3000 births), Wilson’s Disease (disorder of copper metabolism affecting 1:30,000).
•In patients with chronic elevation of liver tests it is important to screen for these chronic liver diseases (CLD) and estimate fibrosis with FIB-4 (age, AST, ALT, platelets) or elastography.
