Gastroenterology and hepatology
Chronic liver disease and cirrhosis
Causes and work-up of chronic liver disease, non-invasive staging, Child-Pugh and MELD, Baveno VIII portal hypertension care, decompensation and HCC surveillance.
Tier 1Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Chronic liver disease is liver injury lasting over 6 months. Fibrosis can progress silently to cirrhosis, and the first sign is often a decompensating event.
- In Australia the commonest causes are MASLD, alcohol, hepatitis C and hepatitis B, often in combination.
- Compensated cirrhosis has a median survival over 12 years. After the first decompensation (ascites, variceal bleeding, encephalopathy, jaundice) it falls to about 2 years.
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Sources
- Therapeutic Guidelines: Gastrointestinal (eTG complete), chronic liver disease and cirrhosisAU/NZTherapeutic Guidelines Limited
- Baveno VIII consensus on portal hypertension and vascular liver disease. J Hepatol 2026. doi:10.1016/j.jhep.2026.07.030Baveno Cooperation / EASL (Journal of Hepatology), 2026
- Biggins SW et al. Diagnosis, evaluation, and management of ascites, spontaneous bacterial peritonitis and hepatorenal syndrome: 2021 practice guidance by the AASLD. Hepatology 2021;74:1014-48American Association for the Study of Liver Diseases, 2021
- Orman ES et al. AGA Clinical Practice Update on the Management of Ascites, Volume Overload, and Hyponatremia in Cirrhosis: Expert Review. Gastroenterology 2025;169:1547-57American Gastroenterological Association, 2025
- EASL Clinical Practice Guidelines for the management of patients with decompensated cirrhosis. J Hepatol 2018;69:406-60European Association for the Study of the Liver, 2018
- Wong F et al. Terlipressin plus albumin for the treatment of type 1 hepatorenal syndrome (CONFIRM). N Engl J Med 2021;384:818-28New England Journal of Medicine, 2021
- de Franchis R et al. Baveno VII: renewing consensus in portal hypertension. J Hepatol 2022;76:959-74Baveno Cooperation / EASL (Journal of Hepatology), 2022
- Singal AG et al. AASLD Practice Guidance on prevention, diagnosis, and treatment of hepatocellular carcinoma. Hepatology 2023;78:1922-65American Association for the Study of Liver Diseases, 2023
- Last updated
- 14 November 2026
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