Alcoholic hepatitis is distinguished from other causes of acute hepatitis by:

• A history of heavy alcohol use (Chapter 106)
• An AST: ALT ratio of ≥2, which is rarely seen in other forms of liver disease

Severe acute alcoholic hepatitis is a life-threatening disease. Treatment with corticosteroid can improve survival, but mortality remains high, with 35% of patients dying within six months.

Seek urgent advice from a hepatologist or gastroenterologist if you suspect alcoholic hepatitis.