Abstract
Recurrent HCV is universal after liver transplantation in patients viremic at the time of transplantation and leads to cirrhosis in up to 30% of patients by five years. This has led to recurrent HCV emerging as an important yet controversial indication for liver retransplantation. Despite encouraging results with pegylated interferon and ribavirin therapy in the non-transplant HCV population, these findings have not translated to transplant recipients where viral eradication is frequently unsuccessful largely due to drug intolerance. The lack of effective therapies, severe side effects and reports of hepatic decompensation despite HCV eradication raises the question of whether recurrent HCV genotype 1 should be treated with interferon-based therapies. Although protease inhibitors were recently approved for the treatment of genotype1 HCV patients in combination with pegylated interferon and ribavirin, these new agents are contraindicated in liver transplant patients due to severe drug toxicity.
Keywords: Hepatitis C, immune suppression, interferon, liver transplantation, recurrent hepatitis C, retransplantation, ribavirin, corticosteroids, Calcineurin inhibitors, Rapamycin, Hepatitis C Virus
Inflammation & Allergy - Drug Targets (Discontinued)
Title: Natural History, Risk Factors and Management of Hepatitis C After Liver Transplantation
Volume: 11 Issue: 2
Author(s): Sandeep Mukherjee
Affiliation:
Keywords: Hepatitis C, immune suppression, interferon, liver transplantation, recurrent hepatitis C, retransplantation, ribavirin, corticosteroids, Calcineurin inhibitors, Rapamycin, Hepatitis C Virus
Abstract: Recurrent HCV is universal after liver transplantation in patients viremic at the time of transplantation and leads to cirrhosis in up to 30% of patients by five years. This has led to recurrent HCV emerging as an important yet controversial indication for liver retransplantation. Despite encouraging results with pegylated interferon and ribavirin therapy in the non-transplant HCV population, these findings have not translated to transplant recipients where viral eradication is frequently unsuccessful largely due to drug intolerance. The lack of effective therapies, severe side effects and reports of hepatic decompensation despite HCV eradication raises the question of whether recurrent HCV genotype 1 should be treated with interferon-based therapies. Although protease inhibitors were recently approved for the treatment of genotype1 HCV patients in combination with pegylated interferon and ribavirin, these new agents are contraindicated in liver transplant patients due to severe drug toxicity.
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Cite this article as:
Mukherjee Sandeep, Natural History, Risk Factors and Management of Hepatitis C After Liver Transplantation, Inflammation & Allergy - Drug Targets (Discontinued) 2012; 11 (2) . https://dx.doi.org/10.2174/187152812800392788
DOI https://dx.doi.org/10.2174/187152812800392788 |
Print ISSN 1871-5281 |
Publisher Name Bentham Science Publisher |
Online ISSN 2212-4055 |
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