24th Congress of the Spanish Liver Transplantation SocietyComplicationHepatitis C Virus Recurrence After Liver Transplantation: How to Treat and When
Section snippets
The Time to Treat HCV Recurrence
Two strategies can be used in these patients: (i) pre-transplantation antiviral therapy with the intention of preventing HCV infection after LT; and (ii) post-transplantation antiviral therapy given with the intent of eradicating the virus in those with established viral or histologic recurrence. The most effective treatment to prevent HCV recurrence is to treat HCV infection before LT. However, this strategy can be used in very few candidates, with compensated cirrhosis or mild decompensated
Results of Antiviral Treatment With Peg-IFN and RBV
Studies with the “preemptive approach” have shown that this strategy is seldom applicable owing to the frequent development of side effects and low proportion of patients in whom therapy can be started because of preexisting conditions such anemia, neutropenia, and thrombocytopenia, with results in terms of SVR of ∼20% [10], [11]. Studies with peg-IFN and RBV given when the disease is established, or the “delayed” approach, is the strategy that has been used in most studies. Antiviral treatment
Treatment of HCV Recurrence With Triple Therapy
Triple therapy with protease inhibitors (PI), boceprevir (BOC), and telaprevir (TPV) in the LT setting is now being evaluated, and results regarding efficacy have been published in the past months, most of them in abstract form. First reports have shown early viral response rates of 60%–100% [17]. Werner et al reported the experience in 12 patients. Eight patients at week 12 of treatment were HCV-RNA negative [18]. Recently, 3 large international series have shown results of end of treatment
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Funding: Instituto de Salud Carlos III (grant # PI13/01770).