for Health Care Providers
Causes of Cirrhosis and Recommended Treatments - Cirrhosis
|Chronic Liver Disease Causes of Cirrhosis||Recommended Treatments|
|Alcoholic liver disease||Abstinence 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 Disease||Chelating agent|