6533b838fe1ef96bd12a3e08
RESEARCH PRODUCT
The road map toward an hepatitis C virus-free transplant population
Patrizia BurraMarina BerenguerMichael MannsKosh AgarwalDidier Samuelsubject
Oncologymedicine.medical_specialtymedicine.medical_treatmentHepatitis C virusinfectious diseasePopulationHepacivirus030230 surgeryLiver transplantationmedicine.disease_causeclinical research/practiceinfection and infectious agents—viral: hepatitis CAntiviral Agents03 medical and health sciencesLiver diseasePostoperative Complications0302 clinical medicineeditorial/personal viewpointInternal medicinemedicineHumansImmunology and Allergyliver disease: infectiousPharmacology (medical)educationclinical research/practice; editorial/personal viewpoint; infection and infectious agents—viral: hepatitis C; infectious disease; liver disease: infectious; liver transplantation/hepatology; Immunology and Allergy; Transplantation; Pharmacology (medical)education.field_of_studyTransplantationbusiness.industrymedicine.diseaseHepatitis CLiver TransplantationTransplantationClinical trialhepatitis C infectious disease liver disease: infectious liver transplantation/hepatology [clinical research/practice editorial/personal viewpoint infection and infectious agents-viral]TolerabilityHepatocellular carcinoma030211 gastroenterology & hepatologybusinessliver transplantation/hepatologydescription
Antiviral therapy to eradicate hepatitis C virus (HCV) infection improves outcomes in patients undergoing liver transplantation (LT) for advanced chronic HCV with or without hepatocellular carcinoma. Traditionally, antiviral therapy focused on the use of interferon (IFN)-based regimens, with antiviral treatment initiated in the posttransplant period once recurrent HCV disease with fibrosis in the allograft was identified. The use of IFN-based therapy was limited in pretransplant patients with advanced liver disease. Earlier intervention, either before transplantation or early after LT, is now feasible with the advent of second-generation direct-acting antiviral agents (DAAs) with superior tolerability and efficacy to IFN-based therapy. These agents have the potential to reduce the number of patients developing HCV-related complications requiring LT and retransplantation, as well as reducing the demand for donor organs. We discuss the pros and cons of pretransplant, peritransplant, and posttransplant therapy with current DAAs, citing available data from clinical trials and real-world experience.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2018-01-01 |