Fibrosis Stage 4, also known as cirrhosis, is the most advanced stage of liver fibrosis. At this stage, the liver is severely scarred, which leads to decreased blood flow and impaired liver function. Symptoms can include fatigue, jaundice, swelling in the legs and abdomen, and mental confusion. Cirrhosis is often caused by long-term alcohol abuse or chronic hepatitis C infection, but can also result from other liver diseases or conditions. Treatment may involve lifestyle changes, medication, and in some cases, liver transplant.