Leverfibros

Leverfibros, commonly referred to as liver fibrosis in English, is a condition characterized by progressive scarring of the liver tissue as a result of chronic liver injury. The scar tissue disrupts the normal liver architecture and can compromise both hepatic function and blood flow.

Causes include chronic viral hepatitis (HBV, HCV), long-term alcohol use, nonalcoholic fatty liver disease, autoimmune hepatitis, cholestatic diseases, and genetic disorders such as hemochromatosis. Coexisting conditions like obesity, diabetes, and metabolic syndrome increase risk and progression.

Pathophysiology involves activation of hepatic stellate cells and other fibrogenic cells in response to injury, leading to deposition of extracellular matrix proteins. Over time, scar tissue forms bridging patterns that distort vessels and bile ducts. Some regression can occur if the underlying cause is removed, especially in early stages.

Diagnosis relies on non-invasive imaging and serum markers, with liver biopsy reserved for uncertain cases or research. Elastography techniques measure liver stiffness and help stage fibrosis (commonly F0 to F4). Serum scores such as FIB-4 and APRI supplement assessment but have limitations.

Management centers on treating the underlying cause (antiviral therapy for viral hepatitis, alcohol abstinence, weight loss for NAFLD, and management of autoimmune or metabolic conditions). Vaccination against hepatitis A and B is recommended. In advanced fibrosis, monitoring for complications and liver cancer risk is important.

Epidemiology varies by region, with nonalcoholic fatty liver disease and alcohol-related liver disease contributing most to fibrosis burden in many populations. The goal is to detect and reverse early-stage fibrosis to prevent progression to cirrhosis and its complications.