Liver fibrosis

Liver fibrosis is a process in which the liver scars due to chronic inflammation. It occurs when the liver is subject to prolonged injury, leading to excessive deposits of extracellular matrix and collagen. Chronic liver disease, such as chronic viral hepatitis (hepatitis B or C) and metabolic-associated steatotic hepatic (fatty liver) disease (MASH) or alcohol-related liver disease, causes fibrosis.

Liver fibrosis itself does not cause symptoms. Instead, the symptoms come from the disease causing the fibrosis or appear when fibrosis develops into cirrhosis.

The continuous inflammation characteristic of fibrosis damages liver cells, including hepatocytes. In response, the hepatic stellate cells, normally inactive, are activated and produce excess collagen, resulting in fibrosis. This process disrupts the structure of the liver and its key functions.

Treatment consists of removing possible causes of fibrosis. How reversible fibrosis is depends on its stage. In the early stages, if liver injury is stopped (losing weight, stopping alcohol, treating hepatitis), the liver may regenerate and fibrosis may regress.

In advanced stages (cirrhosis), it becomes difficult to reverse fibrosis, although some antifibrotic treatments are being developed.

Fibrosis can be detected using conventional or specialized imaging tools, non-invasive blood tests or sometimes a liver biopsy.

Early detection and appropriate care are crucial for preventing it from developing into cirrhosis with its complications.