Transformation. About 90 percent of the food you eat passes through your liver before it can be used. Your liver transforms food into vital body chemicals, including proteins, fats, and cholesterol. It also helps to digest fat and important vitamins carried in fats. When all of this is completed, your liver then sends this nourishment through the blood for cells to use. The normal liver is smooth and firm to the touch. Progressive liver damage can lead to fibrosis, shrinking and hardening, and formation of nodules. In cirrhosis, the liver may become small and hard, with extensive scarring and many nodules.
As mentioned earlier, hepatitis is an inflammation of the liver. As liver disease progresses, other changes occur and damage to the liver increases. For example:
Fibrosis. After becoming inflamed, the liver tries to repair itself by forming tiny scars. This scarring, called “fibrosis,” makes it difficult for the liver to do its job. As damage continues, many scars form and begin to join together, leading to the next stage – cirrhosis. Certain HIV medications can be hard on the liver. It is possible that certain HIV medications may contribute to fibrosis which may lead to cirrhosis.
Cirrhosis. With cirrhosis, large areas of the liver become permanently scarred from repeated damage. The liver begins to shrink and become hard. Chronic viral hepatitis is a common cause of cirrhosis, as is alcoholism. Scarring prevents blood from flowing freely through the liver, severely impairing liver function.
Liver failure.As cirrhosis worsens, most liver function is lost. This means the liver is unable to filter wastes, toxins, and drugs from the blood. It can no longer produce the clotting factors necessary to stop bleeding. Fluid builds up in the abdomen and legs, bleeding in the intestines is common, and eventually mental functioning is slowed. At this point, a liver transplant is the only option.
Liver cancer. Sometimes damage to liver cells includes altering the genes inside cells in a way that causes them to become cancerous. Patients with chronic hepatitis B or C are at higher risk for this form of cancer.