Cirrhosis is fibrosis of the liver, which occurs in end-stage liver disease. It is thought to be a mostly irreversible process. Cirrhosis is characterized by impairment in liver function leading to portal hypertension and potential decompensated cirrhosis hallmarked by ascites development with risk for spontaneous bacterial peritonitis, hepatic encephalopathy, variceal formation and bleeding, hepatorenal syndrome, and hepatocellular carcinoma. All of these decompensating events contribute to a high mortality from cirrhosis and a greatly diminished life expectancy for patients with cirrhosis who do not receive a liver transplant. Cirrhosis is very common in the United States and is a major source of health care expenditures, with indirect and direct costs totaling an estimated $12 billion annually.

Patients with cirrhosis also have an increased risk of infectious complications including urinary tract infection, pneumonia, spontaneous bacteremia, skin and soft tissue infections (eg, Staphylococcus aureus), candidiasis, Clostridioides difficile infection, cholangitis, tuberculosis, and hemochromatosis.

The most common etiologies of cirrhosis are chronic viral hepatitis B and hepatitis C, nonalcoholic steatohepatitis, and alcoholic liver disease. Some patients with cirrhosis have physical examination findings such as jaundice, spider angiomata, palmar erythema, caput medusa, a firm and enlarged liver, or ascites. However, many patients with cirrhosis will have no physical examination findings.

Cirrhosis is a progressive condition that greatly decreases life expectancy. Due to its irreversibility, patients either receive a liver transplant or are at high risk to develop a decompensating event, which carries high mortality.