| [ Summary ] |
The natural history of NASH remains poorly understood due to its intractable nature, the paucity of prospective studies and a lack of consensus regarding the various forms of this disorder. There have been several papers concerning the natural history of NAFLD, NASH, NASH with advanced fibrosis, cirrhotic NASH, and “burned-out” NASH. The rate of progression of cirrhosis in a 5 year period for NASH patients has been estimated to be 10 - 20%. The estimated five-year survival rate is 70 - 95% and 1O - 30% of the causes of death are liver related. Twenty to 50% of cirrhotic NASH patients have complications related to cirrhosis and 70 - 80% of the causes of death are liver related. The mortality rate for cirrhotic NASH depends on its severity. There is a 5-year estimated survival rate of 0 - 90%. The estimated five year rate of development for hepatocellular carcinoma is 0 - 20%. Risk factors for development of hepatocellular carcinoma include older age and advanced stage of the disease. Optimal management of NASH patients will require a clear understanding of the natural history of this disease. Therefore, more research is needed to clarify the natural history of NASH. |