Treatment strategies for chronic hepatitis C prior to and following liver transplantation

World Journal of Hepatology
Ryan B PerumpailAijaz Ahmed

Abstract

Hepatitis C virus (HCV)-related liver disease is the leading indication for liver transplantation (LT) worldwide. However, HCV is an independent predictor of lower survival following LT, and recurrence of HCV post-LT is virtually universal. The historic standard of care during the interferon era of HCV therapy was expectant management-initiation of antiviral therapy in the setting of documented disease progression following LT. With the advent of new direct acting antiviral (DAA) therapies for HCV, the paradigm of expectant treatment for recurrent HCV infection post-LT is shifting. The safety, tolerability, and efficacy of DAAs, even among the sickest patients with advanced liver disease, enables treatment of HCV in the pre-transplant setting among LT waitlist registrants. Finally, emerging data are supportive of preemptive therapy with DAAs in liver transplant recipients as the preferred approach. Expectant management of HCV following LT can rarely be justified in the modern era of HCV therapy.

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Citations

Sep 20, 2016·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Madhukar S PatelParsia A Vagefi
Sep 19, 2017·Liver International : Official Journal of the International Association for the Study of the Liver·Silvia MartiniUNKNOWN ITACOPS study group
Mar 23, 2017·World Journal of Hepatology·Francesca Romana PonzianiAntonio Gasbarrini
Mar 4, 2017·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Aijaz AhmedZobair M Younossi

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