Tomáš Koller, Marek Rác
The knowledge of liver fibrosis stage is of great importance in clinical practice. It allows identifying of the stage of liver
damage which is closely associated with patient prognosis and also with the urgency of treatment. The degree of liver
fibrosis can be reliably detected by the liver biopsy or by a combination of non-invasive markers of biochemical tests
and/or liver elastography. The use of non-invasive modalities in establishing the fibrosis stage needs to be adapted to
the nature of the patient population. Endoscopy should be performed in cases of confirmed cirrhosis to detect the presence
of esophageal varices. Moreover, regular ultrasound scans of the liver should follow to identify possible hepatocellular
carcinoma. The natural history of cirrhosis and the occurrence of liver decompensation or cirrhosis complications
can be predicted by measuring the hepatic venous pressure gradient. Recent studies also confirmed a possible role of
the liver elastography in this clinical setting. Elasticity threshold that predicts liver decompensation depends on the etiology
of liver cirrhosis. Liver fibrosis is a dynamic process and at present we have new evidence of cirrhosis regression
after successful treatment of underlying liver disease.