MANAGEMENT OF CHRONIC LIVER DISEASE AT THE PRIMARY HEALTH CARE LEVEL
DOI:
https://doi.org/10.11603/1811-2471.2026.v.i2.16389Keywords:
risk factors, liver fibrosis (cirrhosis), risk stratification, modern methods, FIB-4 calculator, family medicineAbstract
SUMMARY. Chronic diffuse liver disease (CDLD) is the second leading cause of disability among young and middle-aged Europeans, accounting for 3 % of total mortality. This has led to an unacceptable epidemiological situation, prompting a review of the approach to liver cirrhosis (LC) from the treatment of complications to the prevention of its development in high-risk groups at the primary health care (PHC) level.
The aim – to analyze information and literature sources on the prevalence of the main risk factors (RF) for CLD, methodological approaches to the formation of high-risk groups, and methods for monitoring liver fibrosis (cirrhosis).
Material and Methods. Publications on the early diagnosis and effective management of CDLD were reviewed with the aim of preventing progression and early mortality. The search was conducted using the MEDLINE/PubMed and Index Medicus platforms for the last decade.
Results. CDLD is associated with various risk factors (RFs), among which alcohol use disorders (AUD), obesity, type 2 diabetes (T2DM), and elevated liver enzyme levels are considered the primary – though not the only – triggers for non-invasive liver fibrosis screening. Utilizing tools such as the Fibrosis-4 Index (FIB-4) improves early diagnosis of CDLD, thereby preventing morbidity and mortality from liver cirrhosis. From this perspective, the role of the PHC physician is pivotal in raising community awareness regarding CDLD risk factors, emphasizing the importance of timely diagnosis, and encouraging early treatment. Such involvement is crucial for reducing both the short- and long-term burden of these diseases on public health.
Conclusions. Global strategies for identifying groups with a high pre-test probability of CDLD are primarily based on the assessment of risk factors – most notably AUD, obesity, metabolic syndrome, and T2DM – combined with the FIB-4 index, the value of which determines the subsequent clinical pathway and action plan. The implementation of risk factor identifiers and a FIB-4 calculator into digital medical record systems could optimize the workflow for PHC physicians in selecting patients at high risk for CDLD.
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