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Cirrhosis, or scarring of the liver, occurs over time, as healthy liver tissue dies and is replaced by scar tissue. This damage may cause changes in the DNA, or genetic material, of liver cells, which can eventually lead to cancer. Several conditions increase the risk of developing cirrhosis, including fatty liver disease, NASH, infection with the viruses hepatitis B or C, and heavy alcohol use.

Your doctor may prescribe medication and recommend lifestyle changes—such as following a healthy diet, avoiding alcohol, and getting regular exercise—to help prevent the condition from progressing to cancer.

Fatty liver disease is the buildup of fat in liver cells. There are two types of fatty liver disease—alcoholic and nonalcoholic.

Alcoholic Fatty Liver Disease

Fatty liver disease may develop with heavy alcohol use. The liver breaks down alcohol, but drinking more than the organ can process can cause fat to build up in liver cells. This can permanently damage the liver. However, abstaining from alcohol may help reverse the condition.

Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis

Fat can build up in liver cells if you have excess weight or obesity, diabetes, or high levels of cholesterol or triglycerides, a type of fat found in the blood.

NASH is an advanced form of nonalcoholic fatty liver disease caused by fat buildup in the liver. At this time, the only treatments available for nonalcoholic fatty liver disease are weight loss and control of diabetes, if you have it. Vitamin E may also be helpful for some people. Our hepatologists are participating in of new medications to manage this disease.

People who have been diagnosed with nonalcoholic fatty liver disease may also be able to prevent or reverse early liver damage by eating healthy foods, including fruits, vegetables, and whole grains, and by exercising. These habits can also help you maintain a healthy weight and avoid nonalcoholic fatty liver disease.

Hepatitis B, a virus transmitted through blood and bodily fluids, causes the liver to become inflamed and may lead to cirrhosis. An ongoing or chronic infection with the virus puts you at risk for liver cancer.

Risk factors for infection include having unprotected sex, using injectable drugs with dirty or shared needles, and being on long-term dialysis for kidney disease. Hepatitis B can also be transmitted from mother to child during birth. People who received blood transfusions before 1992, when blood started to be screened for viruses, are also at increased risk.

A vaccine can prevent hepatitis B in adults and children. Avoiding injectable drugs and practicing safe sex can also help reduce the risk of infection.

Most of the time, the immune system can rid the body of the hepatitis B virus. People with chronic hepatitis B infection may receive antiviral medications, which may help prevent cirrhosis and liver cancer.

Like hepatitis B, hepatitis C is a virus transmitted through blood and bodily fluids. It also increases the risk of cirrhosis. People with hepatitis C may be infected for decades without realizing it because the virus often doesn’t cause symptoms.

Many people with hepatitis C have a history of intravenous drug use. People who had blood transfusions prior to 1992 are also at risk, as are those who have had dialysis for kidney disease.

Hepatitis C can be transmitted during unprotected sex, although the risk is low. People with multiple sex partners or those who have HIV infection and AIDS have an increased risk of becoming infected with hepatitis C.

Although there is no vaccine to prevent hepatitis C, you can take several precautions. Avoid sharing personal care items that might have blood on them, such as razors, and practice safe sex by using condoms. If you use intravenous drugs, don’t share needles.

Hepatitis C is more common among the baby boomer generation—those born between 1945 and 1965—than in other age groups. The reasons for this are not entirely understood, although one link may be the popularity of injectable drugs in the 1970s and 1980s, when the rates of infection were at their highest. The Centers for Disease Control and Prevention (CDC) has recommended that anyone born in these years be tested for hepatitis C.

New medications for hepatitis C infection can rid the body of the virus, reverse liver damage, and prevent progression to cirrhosis and liver cancer. NYU Langone doctors were involved in important clinical trials that led to the use of these new therapies.