Posttransplantation prevention and treatment of recurrent hepatitis C

Authors

  • Andrew K. Burroughs MB, CHB, Hons FRCP

    Corresponding author
    1. Department of Liver Transplantation, The Royal Free Hospital, London, UK
    • Department of Liver Transplantation, The Royal Free Hospital, Pond St, Hampstead, London NW2 2QG, UK. Telephone: 44 207 472 6229; FAX: 44 207 472 6226
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Abstract

Key Points

1. Hepatitic C virus (HCV) viremia is universal after orthotopic liver transplantation (OLT) for HCV cirrhosis.

2. At 5 years post-OLT, approximately 20% of patients have cirrhosis caused by recurrent hepatitis C.

3. Progression of disease is related to immunosuppression, immune response (CD4+ lymphocytes), HCV genotype, and HCV quasispecies homogeneity.

4. Whether a therapeutic strategy of pre-OLT or early (preemptive) antiviral therapy is better than treating a clinically important hepatitis and the duration of treatment are not known.

5. Monotherapy with recombinant interferon-α or ribavirin is not useful in the long term.

6. Combination therapy (interferon and ribavirin) has given better results, but long-term data are not available.

7. HCV recurrence will benefit from randomized studies.

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