Liver Cirrhosis: Contemporary Insights into Pathogenesis, Evidence-Based Management, and Emerging Therapeutic Strategies

Liver cirrhosis is the end stage of chronic liver disease, characterized by progressive fibrosis, architectural distortion, and impaired hepatic function. It arises from diverse etiologies including viral hepatitis, alcohol-associated liver disease, non-alcoholic fatty liver disease, autoimmune hepatitis, and cholestatic disorders. Complications such as portal hypertension, hepatic encephalopathy, ascites, and hepatocellular carcinoma significantly impact morbidity and mortality, particularly in decompensated stages. Early identification and etiology-specific treatment, including antiviral therapy, alcohol cessation, and metabolic management, are essential to slow progression. Multidisciplinary care, nutritional optimization, infection prophylaxis, and regular surveillance for hepatocellular carcinoma are key components of effective management. Liver transplantation remains the definitive therapy for selected patients with advanced disease. As global prevalence increases, there is an urgent need for integrated care models, improved access to treatment, and innovations in antifibrotic therapies. This review highlights current strategies and future directions in the comprehensive management of liver cirrhosis.