5 While more people than ever before attempt Dry January, the impact of the pandemic on our drinking habits is still being felt, with a significant rise in the number of people presenting with alcohol-related cirrhosis. New research coming out of RFH could direct help to where it is most needed. Binge drinking According to research from the RFH, UCL, the University of Oxford and the University of Cambridge, people who binge drink and have a certain genetic makeup are six times more likely to develop alcoholrelated cirrhosis (ARC). In the study, published in Nature Communications, researchers analysed data from 312,599 actively drinking adults, to assess the impact of a pattern of drinking, genetic predisposition and type-2 diabetes on the likelihood of developing alcohol-related cirrhosis. When heavy binge drinking and high genetic predisposition were at play, the risk of developing ARC was six times higher than the baseline risk which used data from participants who reported drinking within daily limits, had low genetic disposition to ARC and were free of diabetes. The addition of type-2 diabetes as well resulted in an even greater risk. Dr Gautam Mehta, a senior author of the study from the RFH and UCL Division of Medicine, said: “Only one in three people who drink at high levels go on to develop serious liver disease. While genetics plays a part, this research highlights that pattern of drinking is also a key factor. Our results suggest, for example, that it would be more damaging to drink 21 units over a couple of sessions rather than spread evenly over a week. Adding genetic information, which may be widely used in healthcare over the coming years, allows an even more accurate prediction of risk.” AlcoChange A mobile phone app which encourages patients with alcohol-related liver disease to stay sober could help save hundreds of lives every year, according to the team who developed it. The AlcoChange app uses several behavioural change strategies, including a mobile phone-based breathalyser and personalised messages, to help patients abstain, including telling them how much money they will save by not buying alcohol to sending them pictures of loved ones and providing them solutions to overcome cravings. The breathalyser allows the patients to show their families and friends that they are sober, helping to build trust. A new study, published by researchers from RFH and UCL in the journal JHEP Reports showed that 57% of those using AlcoChange remained abstinent over a three month period, compared with just 22% of those not using the app regularly. This resulted in fewer hospital admissions among the group using the app – even a year after they had stopped using it. Rajiv Jalan, professor of hepatology and consultant physician (UCL and RFL) and the senior author, as well as co-founder of Cyberliver Ltd, which developed the app, said: “It is exciting to see the positive results of this study. Harnessing digital technology has the potential to revolutionise the management of patients with liver disease as it can be delivered continuously at home, reducing the need for patients having to travel and impacting dramatically on costs of healthcare delivery.” A larger randomised nationwide study funded by the National Institute for Health Research has now been launched. Love your liver AlcoChange pioneers Professor Rajiv Jalan, Dr Gautam Mehta and Professor Kevin Moore “It is exciting to see the positive results of this study. Harnessing digital technology has the potential to revolutionise the management of patients with liver disease”
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