A DIAGNOSIS of alcohol-related liver disease (ALD) appears to trigger a marked reduction in alcohol consumption for many patients, although 37% of those who initially stop drinking relapse within three months, according to a new observational study.
The findings suggest a key opportunity for clinicians to support behaviour change early after an ALD diagnosis while highlighting the need for structured follow-up.
ALD is liver damage caused by prolonged harmful alcohol consumption and continued alcohol use is the key driver of disease progression. Researchers found that many patients changed their drinking habits immediately after diagnosis, but biomarker testing indicated abstinence was less common than self-report alone suggested.
Diagnosis Marks a Turning Point in Alcohol Use
Between 2021 and 2025, investigators screened 299 consecutive patients newly diagnosed with ALD at Zealand University Hospital in Denmark, with 104 meeting the study criteria. Participants underwent interviews on current and lifetime alcohol use, motivation to reduce drinking and confidence in achieving abstinence. Researchers also measured phosphatidylethanol (PEth), a blood biomarker of alcohol consumption, before following patients for 90 days.
The cohort had a median age of 64 years, 76% were men and 30% had decompensated cirrhosis. In the five years before diagnosis, 76% reported consuming at least 20 drinks per week following three decades of escalating alcohol use. Shortly after diagnosis, that figure fell to 24%, while 56% reported abstinence. However, PEth results indicated abstinence in only 37% of patients.
Early Relapse Highlights Need for Ongoing Support
Among patients who were abstinent at baseline, 37% relapsed within 90 days. Sustained abstinence was linked to greater motivation to change, stronger confidence in maintaining abstinence and lower baseline PEth concentrations. Neither liver disease severity nor AUDIT scores significantly predicted abstinence after three months.
The findings point to a critical window immediately after diagnosis when many patients appear ready to reduce or stop drinking. At the same time, the 37% relapse rate within three months suggests that motivation alone may not be enough to sustain long-term abstinence.
Researchers said the results support integrating structured alcohol use disorder treatment into liver clinics. They also noted important limitations, including the observational study design, reliance on self-reported alcohol use alongside biomarker testing and the relatively small sample size.
Reference
Kann AE et al. Changes in alcohol use following a diagnosis of alcohol-related liver disease: a clinical cohort study. JHEP Rep. 2026;DOI:10.1016/j.jhepr.2026.101935.
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