Liver fibrosis - Clinics, diagnostics and management

Liver fibrosis results from chronic liver damage and is characterized by scarring of the liver parenchyma. Liver fibrosis can occur in all chronic liver diseases and shows progression towards liver cirrhosis in 20-40% of cases. The clinical presentation of liver fibrosis is usually unspecific. Therefore, most patients with liver fibrosis are identified by elevated liver enzymes during other medical examinations. The gold standard for quantification of liver fibrosis is percutaneous liver biopsy, but non-invasive markers (e. g. serum markers, transient elastography) have recently been evaluated to identify individuals with significant fibrosis. In case of fibrosis detection, medical therapies aim at stabilizing liver scarring or even at inducing the regression of fibrosis. Primarily this is achieved by etiology specific therapies of chronic liver diseases (e. g. antiviral therapy, immunosuppressive therapy etc.). However, in cases of failure of these specific therapies, non-specific interventions for fibrosis regression are actively being investigated. These treatment options are based on the growing molecular knowledge of fibrogenesis but are not yet available for routine clinical use.