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Impact of new treatment options for hepatitis c virus infection in liver transplantation

By Elda Righi, Angela Londero, Alessia Carnelutti, Umberto Baccarani and Matteo Bassetti

Abstract

Liver transplant candidates and recipients with hepatitis C virus (HCV)-related liver disease greatly benefit from an effective antiviral therapy. The achievement of a sustained virological response before transplantation can prevent the recurrence of post-transplant HCV disease that occurs universally and correlates with enhanced progression to graft cirrhosis. Previous standard-of-care regimens (e.g., pegylated-interferon plus ribavirin with or without first generation protease inhibitors, boceprevir and telaprevir) displayed suboptimal results and poor tolerance in liver transplant recipients. A new class of potent direct-acting antiviral agents (DAA) characterized by all-oral regimens with minimal side effects has been approved and included in the recent guidelines for the treatment of liver transplant recipients with recurrent HCV disease. Association of sofosbuvir with ribavirin and/or ledipasvir is recommended in liver transplant recipients and patients with decompensated cirrhosis. Other regimens include simeprevir, daclatasvir, and combination of other DAA. Possible interactions should be monitored, especially in coinfected human immunodeficiency virus/HCV patients receiving antiretrovirals

Topics: Direct antiviral agents, Hepatitis C virus, Liver transplantation, Antiviral Agents, Coinfection, Drug Therapy, Combination, HIV Infections, Hepatitis C, Chronic, Humans, Liver Cirrhosis, Nucleic Acid Synthesis Inhibitors, Postoperative Care, Preoperative Care, Protease Inhibitors, RNA, Viral, Recurrence, Liver Transplantation, Gastroenterology
Publisher: 'Baishideng Publishing Group Inc.'
Year: 2015
DOI identifier: 10.3748/wjg.v21.i38.10760
OAI identifier: oai:air.uniud.it:11390/1086586

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