1. Patients with chronic liver disease usually can be classified as having chronic hepatitis (viral, autoimmune, drug, metabolic, etc) or chronic cholestasis (primary biliary cirrhosis, sclerosing cholangitis, drug, granulomatous, ductopenia, etc.) on the basis of ALT, AST, and Alkaline Phosphatase.

2. If blood tests cannot define the cause of chronic hepatitis, liver biopsy is usually performed either by the percutaneous, transjugular or laparoscopic routes.

3. All forms of chronic liver disease can lead to cirrhosis. Cirrhosis is suspected by physical examination, laboratory tests, and imaging studies. The severity cirrhosis is assessed by clinical scoring systems to determine the Child class.