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Cirrhosis

Scarring and permanent injury to the liver, usually the result of chronic, long term damage.

PubMed Health Glossary
(Source: NIH - National Institute of Diabetes and Digestive and Kidney Diseases and National Library of Medicine)

About Cirrhosis

A healthy liver is necessary for survival. The liver can regenerate most of its own cells when they become damaged. However, if injury to the liver is too severe or long lasting, regeneration is incomplete, and the liver creates scar tissue. Scarring of the liver, also called fibrosis, may lead to cirrhosis.

The buildup of scar tissue that causes cirrhosis is usually a slow and gradual process. In the early stages of cirrhosis, the liver continues to function. However, as cirrhosis gets worse and scar tissue replaces more healthy tissue, the liver will begin to fail.

Chronic liver failure, which is also called end-stage liver disease, progresses over months, years, or even decades. With end-stage liver disease, the liver can no longer perform important functions or effectively replace damaged cells... NIH - National Institute of Diabetes and Digestive and Kidney Diseases

What works? Research summarized

Evidence reviews

Transient elastography with suspected fibrosis and cirrhosis of the liver [Internet]

Evidence supporting colchicine for alcoholic, viral, and cryptogenic liver fibrosis/cirrhosis is still lacking

Alcohol and hepatotropic viruses are major causes of liver fibrosis and liver cirrhosis. Colchicine is an anti‐inflammatory and anti‐fibrotic drug. This systematic review could not demonstrate any significant beneficial effects of colchicine on mortality, liver‐related mortality, liver complications, liver biochemistry, or liver histology of patients with liver fibrosis or liver cirrhosis due to alcohol, hepatitis B, hepatitis C, or unknown etiology. Colchicine was associated with a significant increase in adverse events. Accordingly, there seems to be no evidence for using colchicine for alcoholic, viral, or cryptogenic liver fibrosis/cirrhosis outside randomised clinical trials.

Cyclosporin A was without significant effects on mortality, liver transplantation, or progression of primary biliary cirrhosis, and patients given cyclosporin A experienced more adverse events

Primary biliary cirrhosis (PBC) is a chronic disease of the liver that is characterised by destruction of bile ducts. Estimates of annual incidence range from 2 to 24 people per million population, and estimates of prevalence range from 19 to 240 people per million population. PBC primarily affects middle‐aged women. The forecast for the symptomatic patient after diagnosis is between 10 and 15 years. The cause of PBC is unknown, but the dynamics of the disease resemble the group 'autoimmune disease'. Therefore, one might expect a noticeable effect of administering an immune repressing drug (immunosuppressant). This review evaluates all clinical data on the immunosuppressant cyclosporin A for PBC.

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Summaries for consumers

Ledipasvir / sofosbuvir (Harvoni) for chronic hepatitis C: Ledipasvir / sofosbuvir (Harvoni) for hepatitis C (genotype 1) in people with liver cirrhosis who have had no previous treatment

In early 2015, the Institute for Quality and Efficiency in Health Care (IQWiG, Germany) looked into the advantages and disadvantages of ledipasvir / sofosbuvir compared with standard therapies for the treatment of hepatitis C infection.The following results apply to cases of chronic hepatitis C (genotype 1) in people with liver cirrhosis who have had no other previous treatment. The patients did not also have an HIV infection. For this group, IQWiG performed a historical comparison with data from a total of ten studies. One of these studies looked into treatment with ledipasvir / sofosbuvir, and the other nine examined the double combination of peginterferon alfa and ribavirin.

Ledipasvir / sofosbuvir (Harvoni) for chronic hepatitis C: Ledipasvir / sofosbuvir (Harvoni) for hepatitis C (genotype 1) in people without liver cirrhosis who have had no previous treatment

In early 2015, the Institute for Quality and Efficiency in Health Care (IQWiG, Germany) looked into the advantages and disadvantages of ledipasvir / sofosbuvir compared with standard therapies for the treatment of hepatitis C infection.The following results apply to cases of chronic hepatitis C (genotype 1) in people without liver cirrhosis who have had no other previous treatment. The patients did not also have an HIV infection. For this group, IQWiG carried out a historical comparison with data from a total of nine studies. Three of these studies looked into treatment with ledipasvir / sofosbuvir and the other six examined the triple therapy with peginterferon alfa, ribavirin, and boceprevir or telaprevir.

Evidence supporting colchicine for alcoholic, viral, and cryptogenic liver fibrosis/cirrhosis is still lacking

Alcohol and hepatotropic viruses are major causes of liver fibrosis and liver cirrhosis. Colchicine is an anti‐inflammatory and anti‐fibrotic drug. This systematic review could not demonstrate any significant beneficial effects of colchicine on mortality, liver‐related mortality, liver complications, liver biochemistry, or liver histology of patients with liver fibrosis or liver cirrhosis due to alcohol, hepatitis B, hepatitis C, or unknown etiology. Colchicine was associated with a significant increase in adverse events. Accordingly, there seems to be no evidence for using colchicine for alcoholic, viral, or cryptogenic liver fibrosis/cirrhosis outside randomised clinical trials.

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More about Cirrhosis

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Other terms to know:
Fibrosis

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