Q. I would like to seek information regarding liver cirrhosis, a condition my mother has. I would like to know if this disease is contagious or not and if this disease is still curable.

--Bernard@yahoo.com

A. Cirrhosis refers to severe scarring of the liver that develops when the liver is subjected to chronic, repeated or sustained injury.

The liver is a vital organ. Its cells, known as hepatocytes, perform numerous metabolic functions. Under normal conditions, the liver can regenerate itself, which means hepatocytes that are injured and die are replaced by new hepatocytes that then take over the function of the dead ones. However, in cases of chronic or repeated injury, the liver is not able to regenerate itself. Instead, the hepatocytes that are lost are replaced not by other hepatocytes but by non-functioning scar tissue, which over time leaves the liver severely scarred, a condition called cirrhosis.  

Cirrhosis has various causes, the more common are habitual alcohol consumption, chronic hepatitis B, C or D, and non-alcoholic fatty liver disease—a condition that is associated with obesity, diabetes, malnutrition and certain drugs such as steroids. Less common causes of cirrhosis include prolonged exposure to toxic chemicals, parasitic infections, autoimmune hepatitis, and certain relatively rare inherited diseases such as cystic fibrosis and hemochromatosis. Cirrhosis is not a contagious, but some of its causes are (e.g., viral hepatitis). 

Among Filipinos, and I suspect this is true in the case of your mother, the main cause of cirrhosis is chronic hepatitis B, which is caused the hepatitis B virus (HVB). Other less significant causes of cirrhosis in the Philippines are chronic hepatitis C infection and alcoholism.

Chronic hepatitis B is a major public health problem in the country. It afflicts between 10-12% of all Filipinos, (i.e., more than 8 million Filipinos). The hepatitis B virus (HBV) is mainly transmitted by the parenteral route (i.e., use of contaminated needle for injection and transfusion of infected blood) and by sexual intercourse. But the virus also spreads through contact with body fluids like saliva, tears, breast milk and urine. An infected mother can likewise transmit the virus to her baby during delivery.

In most cases, hepatitis B is a self-limiting disease that leaves no permanent damage to the liver. However, in about 10% of people that get the infection, the virus persists for months to years and results in chronic hepatitis B, which results in progressive damage to the liver and eventually, cirrhosis.

Actually, the incidence of chronic hepatitis is higher with hepatitis C, but hepatitis B presents a bigger public health problem in the Philippines because there are more cases of hepatitis B than C.

The liver damage that accompanies cirrhosis is irreversible. The goals of treatment are to slow down or stop the formation of scar tissue and prevent or manage the life-threatening complications of the disease. Inasmuch as cirrhosis can be caused by a variety of factors, the specific treatment for the condition depends on the underlying cause.

The common complications of cirrhosis, which appear only when much of the liver has already been damaged, include bleeding that can be secondary to the failure of the liver to produce enough blood clotting factors, or to portal hypertension due to obstruction of the vein that brings blood from the digestive tract to the liver; jaundice; hepatic encephalopathy that results from the build up in the brain of the toxins that the liver fails to remove from blood; susceptibility to infection; kidney and lung failure; and, liver cancer.  Cirrhosis of the liver precedes 80% of all liver cancers, thus, any condition that predisposes to cirrhosis indirectly causes liver cancer.

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