Description of current strategies for preventing chronic liver damage in Chile

Abstract

Introduction: Hepatocellular carcinoma is the most common primary malignant neoplasm of the liver. Risk factors for hepatocellular carcinoma include metabolic liver disease (particularly non-alcoholic fatty liver disease), excessive alcohol consumption, chronic hepatitis B, and hepatitis C, all of which are preventable. Multiple interventions are used worldwide for its prevention; however, there is currently no Ministry of Health document that directly addresses the prevention strategies used in Chile. Objectives: To review and describe the interventions used in Chile in primary prevention with regard to the main aetiologies of chronic liver damage, as well as interventions according to the level of secondary and tertiary prevention. Methodology: A literature review was conducted of both national grey literature and indexed literature through a systematic search using medical subject headings and free terms. Results: The review categorises prevention according to levels: primary, secondary and tertiary. Primary prevention covered the risk factors for hepatocellular carcinoma. With regard to secondary prevention, diagnosis and screening with imaging are addressed, while tertiary prevention describes existing treatments. Conclusion: At the primary level, no measures are described for the secondary and tertiary prevention of chronic liver damage due to alcohol (the second leading cause nationwide). At the secondary level, there are no clinical guidelines from the Ministry of Health that address the monitoring of liver cirrhosis, and it is not currently included in the explicit health guarantees.