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 D-penicillamine Zinc Trientin |
