Liver Fibrosis: A Clinical Update

Abstract

Liver fibrosis is a disease that affects patients with hepatitis B virus or hepatitis C virus, harmful alcohol consumption levels, and nonalcoholic fatty liver disease. It is important to assess the cause, disease severity, and prognosis at the time of presentation to determine suitable treatment. The aim of this review article is to outline the recent advances in the diagnosis, management, and treatment of liver fibrosis. A PubMed review was performed encompassing the years 1982–2019 using the following search terms: ‘liver fibrosis’, ‘hepatitis C virus’, ‘hepatitis B virus’, ‘non-alcoholic fatty liver disease’, and ‘alcoholic liver disease’. Results showed that the cornerstone therapy for liver fibrosis is to remove the offending agent and treat the underlying disease. The gold standard method of diagnosis is liver biopsy; however, this procedure is invasive and thus multiple laboratory and radiologic tests are used to help determine the degree of fibrosis. There are few pharmacological agents known to treat fibrosis and they are disease specific. For example, the only proven therapy for fibrosis improvement in alcoholic liver disease is abstinence. The authors concluded that liver fibrosis carries a high morbidity and mortality risk with few therapeutic options depending on the cause and degree of fibrosis. Larger multicentre prospective studies are needed to examine effective agents to prevent, stop, or reduce fibrosis.