Condition caused by chronic damage to the liver.

Etiology:- Hepatotoxicity→ Long-standing alcohol abuse (one of the most common causes of chronic liver disease in the USA)→ Medications (e.g., acetaminophen, amiodarone or chemotherapy drugs such as methotrexate)→ Ingesting aflatoxin created by Aspergillus- Inflammation→ (Chronic) viral hepatitis B, C, and D → Primary biliary cirrhosis→ Primary sclerosing cholangitis→ Autoimmune hepatitis- Parasitic infections (e.g., schistosomiasis, leishmaniasis, malaria)- Metabolic disorders→ Non-alcoholic steatohepatitis (NASH) → Hemochromatosis→ Wilson's disease→ Alpha‑1 antitrypsin deficiency- Hepatic vein congestion or vascular anomalies→ Budd-Chiari syndrome→ Cardiac cirrhosis (congestive hepatopathy)

Classification: Child-Pugh score- Parameters: Serum albumin, serum bilirubin, INR, ascites, hepatic encephalopathy

Pathology:- Fibrosis- Bile duct proliferates- Replacement of normal liver tissue with collagenous regenerative nodules (histological staging is based on the size of the regenerative nodules)Micronodular = 1-3 mm→ Following a chronic active process, e.g. chronic hepatitis B or C; alcoholic hepatitisMacronodular = > 3 mm→ Following diffuse parenchymal necrosis with relapses or acute course; e.g. relapse or fulminant viral hepatitis; intoxications (e.g., death cap poisoning)