A systematic review of population-based studies (2000–2025) from 7 countries synthesizing annual incidence rates of alcohol-associated hepatitis (AH); no comparator intervention was evaluated.
Across 11 studies, AH incidence ranged from 1.02 per 100,000 (Iceland) to 98.5 per 100,000 (United States), with a median of 6.8 per 100,000 (IQR 4.2–19); 7 of 9 studies with repeated estimates showed an **increasing** incidence trend over time. Two studies documented a surge during COVID-19, with one showing gradual return to pre-pandemic levels. No prevalence data were available.
- High heterogeneity in case definitions across studies limits comparability. - No prevalence data exist; only incidence estimates were available. - Only 11 studies from 7 countries were included, leaving most of the world uncharacterized.
AH incidence appears to be rising globally over the past 25 years — clinicians should maintain a low threshold for early recognition and workup, especially post-pandemic. Standardized diagnostic criteria are urgently needed to improve epidemiological tracking and resource planning.
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