from Section 6 - Viral Infections
Published online by Cambridge University Press: 18 June 2025
Hepatitis is an inflammation of the liver that is caused by a variety of infectious and non-infectious agents leading to a wide range of health problems, ranging from acute transient self-limiting infections to chronic insults causing liver fibrosis, cirrhosis and malignancy. Chronic liver disease (CLD) arises in the context of a continuous cycle of inflammation, destruction and regeneration of liver parenchyma. Development of liver fibrosis may be reversible in the initial stage but will progress to irreversibility if the underlying drivers are not recognized and removed e.g. stopping drinking alcohol. The transition time point of reversible fibrosis to irreversible fibrosis is still not completely understood. Liver cirrhosis is a final stage of chronic liver disease that results in disruption of liver architecture, the formation of widespread nodules, vascular reorganization, neo-angiogenesis and deposition of an extracellular matrix. In the initial stages, cirrhosis is compensated. Most patients are asymptomatic at this stage, and cirrhosis is usually discovered incidentally during medical encounters for other reasons. Thus, reports on the prevalence of compensated cirrhosis are almost always underestimated. The 5-year survival rate in cirrhotic CLD is around 50%.
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