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Post-Liver Transplant Management of Hepatitis C

  • Hepatitis C (J Ahn, Section Editor)
  • Published:
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Abstract

Recurrent hepatitis C virus (HCV) infection confers higher complication and mortality rates in liver transplant (LT) recipients. Prior treatment with interferon (IFN)-based regimens yielded poor response and many adverse reactions. Recently, direct-acting antiviral agents have replaced IFN-based therapy; these are highly effective in LT patients, regardless of previous treatment experience or presence of advanced fibrosis or cirrhosis, and even with hepatic decompensation. However, specific clinical conditions frequently encountered in this population may still impact the safety and tolerability of HCV treatment, and should be carefully considered prior to initiation of therapy. Once a difficult-to-treat disease and a threat to graft and patient survival, recurrent HCV has now become highly curable and will cease to be a major cause of graft loss or patient mortality in LT recipients.

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Abbreviations

AASLD:

The American Association for the Study of Liver Disease

IDSA:

Infectious Disease Society of North America

CrCl:

Creatinine clearance

CPT:

Child-Pugh-Turcotte

DAA:

Direct-acting antiviral

EASL:

European Association for the Study of Liver Disease

FCH:

Fibrosing cholestatic hepatitis

GT:

genotype

HCV:

Hepatitis C Virus

IFN:

Interferon

NS5B:

Nonstructural protein 5B

NNPI:

NS5B non-nucleoside polymerase inhibitor

NPI:

Nucleoside polymerase inhibitor

NS3/4A:

Nonstructural proteins 3/4A

NS5A:

Nonstructural protein 5A

P-IFN:

Pegylated interferon-α

PI:

Protease inhibitor

SVR:

Sustained virological response at 12 weeks or more after treatment

RAV:

Resistance-associated variant

PrOD:

Ritonavir-boosted paritaprevir/ombitasvir and dasabuvir

PrO:

Ritonavir-boosted paritaprevir/ombitasvir

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Correspondence to Helen S. Te.

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Conflict of Interest

TD declares that he has no conflicts of interest. HST reports grants from Abbvie, Inc., grants from Gilead Sciences, Inc., advisory board service for Bristol Meyers Squibb, advisory board service for Intercept Pharmaceuticals, and grants from Conatus Pharmaceuticals, outside the submitted work.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Hepatitis C

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Dong, T., Te, H.S. Post-Liver Transplant Management of Hepatitis C. Curr Hepatology Rep 15, 167–177 (2016). https://doi.org/10.1007/s11901-016-0310-1

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