Cirrhosis Essay

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CRITICAL REVIEW ON TREATMENT AND PREVETION OF HEPATIC CIRRHOSIS AND FIBROSIS

INTRODUCTION
Liver cirrhosis is a common outcome in clinical progressions of all chronic liver diseases, distinguished by substitution of tissues of the liver by fibrous (scar) tissues. Regenerative nodules - lumps that appear in a bid to repair the damaged tissues – also replace the liver tissues, leading to an alteration of the liver structure to into structurally abnormal nodules. Liver fibrosis is as a resultant effect of the propagation of the process of healing of wounds, leading to fibrogenesis - an uncharacteristic obstinate process of connective tissue production and removal (Anthony, 1978).
It has been reported that cirrhosis occurs in roughly 20 % of individuals
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Source: www.lookfordiagnosis.com

Blood tests can also be used to determine:
Alkaline phosphatase (ALP): High Alkaline phosphatase level specifies a block in the bile duct.
Bilirubin: This is a red-yellowish colouring that is usually digested in the liver and subsequently expelled in the bile. An injured liver will not have the capacity to process bilirubin, and blood levels of bilirubin increases.
Prothrombin time (PT): This test determines in seconds the time taken for formation of blood clots, with longer time taken indicating higher risk of bleeding. An abnormal PT is mostly caused by liver disease.

Table 2: Laboratory tests and findings in cirrhosis based on description and cause (data: Sherlock et al., 2002)

PREVENTION AND
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Before the advent of DAAs, peginterferon and ribavirin were used in treatment of cirrhosis. Ribavirin was observed to have antiviral activity against HCV in studies performed in the early 1990s (Reichard, et al., 1991), studied in combination with interferon beta by 1993 (Kakumu et al., 1993). By 1995, interferonalfa was used in combination with ribavirin in treating patients who had deteriorated on interferon monotherapy . In 2002, pegylated interferon (peginterferon) was developed and tested, which led to reduced frequency of injections- weekly rather than three times per week (Fried et al., 2002). Apart from their limited effectiveness, peginterferon and ribavirin also led to an increase in the risk of unfavourable events in cirrhotic patients, predominantly those with any signs of decompensation (Fried et al.,

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