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A risk factor is something that increases your likelihood of getting a disease or condition.

It is possible to develop cirrhosis with or without the risk factors listed below. However, the more risk factors you have, the greater your likelihood of developing cirrhosis. If you have risk factors for cirrhosis, ask your doctor what you can do to reduce your risk. Even one or two risk factors is reason enough to consult a provider.

Excessive Alcohol Consumption

Increased consumption of alcohol over a long period of time puts you at a higher risk for developing cirrhosis.

Alcohol is toxic to liver cells. It also damages the liver by changing how your body breaks down food. People who abuse alcohol also tend to have poor diets, which may also contribute to cirrhosis.

Cirrhosis does not develop in everyone who drinks but most cirrhosis develops because of alcohol abuse.

Medical Conditions
Chronic Infection with Hepatitis B, C, or D

Some acute viral hepatitis infections become chronic, leading to liver inflammation and injury that. Over time, this can progress to cirrhosis. Common viral infections include:

  • Infection with the hepatitis B virus —World Health Organization (WHO) statistics show that 2 billion individuals are initially infected with hepatitis B virus and 350 million remain infected chronically and become carriers of the virus. The rate of hepatitis B infection is highest among Asians and Pacific Islanders and second highest among non-Hispanic blacks.
  • Acute infection with hepatitis C — becomes chronic in about 80% of infected adults. About 10%-15% of people with chronic hepatitis C will develop cirrhosis, usually over many years. The rate of hepatitis C infection is highest among non-Hispanic blacks.
  • Hepatitis D — infects people who are already infected with hepatitis B.
Nonalcoholic Steatohepatitis (NASH)

With NASH, fat cells build up in the liver and eventually lead to scarring. This type of hepatitis is associated with:

Secondary Bilary Cirrhosis

Blockage of the bile ducts causes bile to back up and damage liver tissue. In adults, this can occur with a condition called primary biliary cirrhosis, in which the bile ducts become inflamed, blocked, and scarred.

Bile ducts may also be blocked due to a disease called primary sclerosing cholangitis. It can also occur as a result of gallstones , or as a complication of gallbladder surgery if the ducts are accidentally tied off or injured. It can result from inflammation of the pancreas, called pancreatitis . In infants, blocked bile ducts may result from biliary atresia, a condition in which the bile ducts are injured or totally absent from birth.

Hepatic Congestion

Conditions such as heart failure or constrictive pericarditis can cause congestion within the liver and eventually lead to scarring.

Inherited Disorders

Numerous inherited disorders interfere with the way the liver produces, processes, and stores enzymes, proteins, metals, and other substances necessary for proper functioning of the body. They include:

  • Hemochromatosis —an inherited disorder that causes the body to absorb and store too much iron, which builds up in various organs, including the liver, and causes damage
  • Wilsons disease —an inherited disorder that results in excessive copper accumulation in the body, which also can produce liver damage
  • Alpha-1 antitrypsin deficiency—an inherited deficiency of a protein produced in the liver that normally functions to block the destructive effects of certain enzymes; may lead to liver disease and emphysema
  • Galactosemia—an inherited disorder characterized by the inability of the body to use the simple sugar galactose; leads to an accumulation of galactose 1-phosphate, which causes damage to the liver, central nervous system, and various other body systems
  • Glycogen storage diseases—a group of inherited disorders caused by a lack of one or more enzymes that results in excessive storage of glycogen in the liver and eventual liver damage
  • Cystic fibrosis —a genetic disorder the can result in liver damage
  • Budd-Chiari syndrome—a condition caused by a blood clot which blocks the veins that carry blood from the liver into the inferior vena cava. The vena cava is the large vein which carries blood from the left side of our body back to the heart.
Autoimmune Hepatitis

This is a condition in which immune cells mistake normal liver cells as invading cells and attack them.

Other Factors

The following factors can lead to liver damage include :

  • Severe adverse reactions to prescription drugs, such as isoniazid and methotrexate
  • Chronic exposure to environmental toxins such as arsenic
  • Repeated episodes of heart failure with liver congestion
  • The parasitic infection schistosomiasis

References:

Cirrhosis. American Liver Foundation website. Available at: http://www.liverfoundation.org/abouttheliver/info/cirrhosis. Updated December 3, 2012. Accessed April 24, 2013.

Cirrhosis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 27, 2012. Accessed April 24, 2013.

Cirrhosis. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/cirrhosis/index.aspx. Updated February 21, 2012. Accessed April 24, 2013.

Heidelbaugh JJ, Bruderly M. Cirrhosis and Chronic Liver Failure: Part I. Diagnosis and Evaluation. Am Fam Physician. 2006;74:756-762.

Hepatitis B. World Health Organization website. Available at: http://www.who.int/immunization/topics/hepatitis_b/en/index.html. Updated July 12, 2012. Accessed April 24, 2013.

2/12/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Chang Y, Ryu S, et al. Weight gain within the normal weight range predicts ultrasonographically detected fatty liver in healthy Korean men. Gut . 2009;58(10):1419-1425.



Last reviewed March 2014 by Daus Mahnke, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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