Systematic review: hepatic fibrosis – regression with therapy

SUMMARYBackgroundHepatic fibrosis occurs in response to chronic liver injury, regardless ofthe cause. An impressive amount of knowledge concerning the patho-genesis and treatment of liver fibrosis has emerged over the past fewyears. The hallmark of this event is the activation of the hepatic stellatecell. The latter event causes accumulation of extracellular matrix andformation of scar, leading to deterioration in hepatic function.AimTo assess chronic liver injury, many invasive and non-invasive methodshave been suggested.MethodsAlthough transient elastography, image analysis of fractal geometry andfibrotest with actitest have been used in clinical practice, liver biopsyremains the recommended choice, especially when histological stagingof fibrosis or response to treatment is needed.ConclusionsThe recent advances in anti-viral therapy have resulted in many reportson fibrosis and even on cirrhosis regression, especially early and inyoung people. A number of new agents have been suggested for thetreatment of fibrosis, with promising results in animals; however, theirefficacy in humans remains to be elucidated. The investigation of hetero-geneity and plasticity of hepatic stellate cells is a topic of scientificinterest and may result in improvements in patient management.