Liver fibrosis is excess growth of fibrous tissue in liver, caused by chronic inflammation and death of liver cells, which is seen in mostly all chronic liver diseases.

Liver fibrosis is the beginning of cirrhosis.
Chronic liver inflammation cause liver cells damage, which increase the growth of fibrous tissue in liver. Liver is known to have the ability to regenerate healthy cells to replace damaged cells. However, if the inflammation is too severe and overweight liver’s regenerative capacity, the growth of fibrous tissue will increase. Accumulation of fibrous tissue will lead to formation of scar tissue, causing the liver structure to hardened, which will lead to cirrhosis.

Stage of Liver Fibrosis:
  1. Stage 0: normal liver
  2. Stage 1: mild fibrosis, enlargement of hepatic portal as a result of fibrosis
  3. Stage 2: moderate fibrosis, the fibrous tissues have come out from the hepatic portal area and form bridges between the portal areas.
  4. Stage 3: severe fibrosis, fibrostic bridges are formed between the portal areas and liver’s center veins
  5. Stage 4: cirrhosis

Early stages of liver fibrosis (stage 1 and 2) are reversible, which means in these conditions, liver still has the ability to regenerate damaged liver cells.

Cause of liver fibrosis:
  1. Virus
    Most common cause is hepatitis B and hepatitis C virus. Hepatitis B and hepatitis C carriers are advised to always maintain their health conditions in order to prevent the virus from infecting the liver and causing liver inflammation, which will lead to fibrosis, chronic hepatitis, liver fibrosis, and cirrhosis.
  2. Alcohol
    Over-consumption of alcohols in long-term period causes liver cells necrosis, alcohol-induced hepatitis, liver fibrosis, and cirrhosis.
  3. Metabolic diseases
    Metabolic diseases such as iron deposition disease, copper deposition disease, and Wilson’s disease can cause liver fibrosis.
  4. Fatty liver
    Obesity and consumption of high cholesterol foods can cause fatty liver. A small percentage of people with fatty liver caused by liver fats inflammation will have liver fibrosis.
  5. Drugs
    Usage of wrong drugs and medications may damage the liver cells and cause liver fibrosis.

Liver fibrosis is asymptomatic. In most case, liver fibrosis is diagnosed during medical check-up. This is because human’s liver only needs 20-30% of normal liver cells to function normally. In addition, liver also lacks the neurons that transmit the pain signals. Hence, most patients are not aware of their liver fibrosis disease, even if the liver has started to harden.
Minority of the patients will experience symptoms such as jaundice and fatigue.

Prevention and treatment
No treatment is available for patients with severe fibrosis and cirrhosis. Hence, it is important to prevent liver damage. Liver has a great regenerative ability if the causes of fibrosis can be controlled. There are few preventive measures:
  1. Hepatitis carrier should do regular check-up
  2. People who are diagnosed with hepatitis should undergo medication to inhibit virus development and fibrosis.
  3. Reduce alcohol intake. Termination of alcohol consumption will be better.
  4. Maintain ideal body-weight
  5. Avoid drug abuse
  6. Regular exercise and sufficient rest
  7. Consumption of healthy and balanced food.
  8. Consumption of supplements that help to maintain liver functions

- Bataller R and Brenner A., 2005, Liver Fibrosis