Cirrhosis is the pathological end-stage of any chronic liver disease - characterised by fibrosis and conversion of normal liver architecture to structurally abnormal nodules (regenerative nodules)

Aetiology:

Most commonly results from:

• Chronic Hep-B
• Chronic Hep-C
• Alcohol-related fatty liver disease
• Non-alcohol related fatty liver disease

In the US and Europe the major cause of cirrhosis is alcoholic liver disease. Worldwide, hepatitis B virus infection and hepatitis C virus infection are the major causes of cirrhosis

Less common causes:

• Autoimmune:
  • Autoimmune hepatitis
  • Primary biliary cirrhosis
  • Primary sclerosis cholangitis
  • Sarcoid
• Genetic:
  • Haemochromatosis
  • Wilson's disease
  • Alpha-1-antitrypsin deficiency
• Drugs:
  • Methotrexate
  • Amiodarone
  • Isoniazid
• Others:
  • Budd-Chiari Syndrome
  • Heart failure
  • Tertiary syphilis

Risk factors:

• Alcohol misuse
• IV drug use - Risk of Hep B/C
• Unprotected intercourse - Risk of Hep B/C
• Obesity - NAFLD