Liver Fibrosis: Clinical Perspectives

Liver fibrosis is a pathological condition of the liver that occurs due to chronic damage to the liver along with the accumulation of extracellular matrix proteins. These proteins act to form a fibrous scar. Such liver injury is caused due to chronic hepatitis C virus infection, non-alcoholic steatohepatitis (NASH) and alcohol abuse. Besides these, hepatitis B infection, primary sclerosis, primary biliary cirrhosis and cholangitis may also contribute to liver fibrosis. With time, as the liver becomes more scarred, a condition known as cirrhosis sets in. The progression of fibrosis is usually stealthy with minor symptoms, such as appetite loss, fluid buildup in legs or stomach, nausea, jaundice, etc. This progression from fibrosis to cirrhosis can take close to 15-20 years and is largely determined by both genetic and environmental factors. Various complications such as renal failure, ascites, hepatic encephalopathy and variceal bleeding may occur. It is usually detected at an advanced stage. The underlying cause of the fibrosis can be usually treated. Different antifibrotics may be prescribed to reduce scarring. In its advanced stage, the only treatment modality available is a liver transplantation. This book covers in detail the clinical perspectives in the pathophysiology and development of liver fibrosis. Different approaches, evaluations, methodologies and advanced studies on liver fibrosis and cirrhosis have been included herein. It is a collective contribution of a renowned group of international experts.