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Viral Hepatitis and Liver Disease

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Causes of Cirrhosis and Recommended Treatments

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Causes of Cirrhosis and Recommended Treatments - Cirrhosis

Causes of Cirrhosis and Recommended Treatments
Chronic Liver Disease Causes of CirrhosisRecommended Treatments
Alcoholic liver diseaseAbstinence from alcohol
Alpha-1 Antitrypsin Deficiency phenotype (Z and M alleles)No treatment
Autoimmune hepatitis (AIH)Prednisone or combination of prednisone and azathioprine, depending on symptoms, lab findings, and histological findings.
Uncertain indication for treatment in absence of mild symptoms, mild laboratory, and/or histological findings.
Chronic hepatitis B virus (HBV)All patients with cirrhosis and HBV should be treated with HBV antivirals, regardless of ALT and HBV DNA levels.
For patients without cirrhosis, treatment recommendations depend on HBeAg status, degree of ALT elevation, degree of HBV DNA elevation, and/or fibrosis stage.
Patients not meeting current criteria for HBV antivirals require lifelong monitoring of HBV tests and liver tests, and may be treated if their HBV markers change with time.
Chronic hepatitis C virus (HCV)Direct-acting antiviral drugs (DAAs)
Hemochromatosis Phlebotomy (repeated, over lifetime), though no benefit to phlebotomy if liver disease is advanced.
Non-alcoholic fatty liver (NAFL)Weight loss
Increased physical activity
Control of dyslipidemia
Control of hyperglycemia
Primary biliary cirrhosis (PBC)Ursodeoxycholic acid (UDCA) alone or in combination with obeticholic acid
Primary Sclerosing Cholangitis (PSC)No current treatment available
Wilson's DiseaseChelating agent
D-penicillamine
Zinc
Trientin