Liver Fibrosis : A Clinical Update

Liver fibrosis is the common sequelae of chronic insult to the liver from any aetiology. The most common causes are alcohol-related, fatty liver disease, chronic hepatitis B or C viral infections, autoimmune hepatitis, and metabolic or genetic liver diseases. The disease spectrum of liver fibrosis ranges from non-cirrhotic (stages F0–F3) to cirrhotic (stage F4). Fibrosis is the replacement of tissue with a collagenous scar as a result of repetitive liver insults. Cirrhosis is the end stage of liver fibrosis resulting in regenerative nodular hepatic echotexture surrounded by fibrotic bands and distortion of hepatic vasculature.1,2 Liver fibrosis is a major cause of morbidity and mortality.3 A survey by the Centers for Disease Control and Prevention in 2016 found that there were 4.9 million people living with liver disease.4 Chronic liver disease and cirrhosis is the sixth leading cause of all-cause mortality in people aged 25–64 years.5 Patients may be asymptomatic or present with a wide range of symptoms, including decompensation and liver failure. Liver biopsy is the gold standard for Abstract