Session I—Hepatitis C
Natural history of recurrent hepatitis C
- 1After liver transplantation for hepatitis C virus (HCV)-related cirrhosis, recurrence of infection is universal, with development of histological hepatitis in the majority of patients.
- 2The natural history of recurrent hepatitis C is highly variable. Although 30% to 50% of patients develop posttransplantation viremia with minimal liver injury, 10% to 30% progress to cirrhosis after a median of 5 years.
- 3Progression of hepatitis C is accelerated in immunocompromised liver transplant recipients compared with immunocompetent patients, both before and after the development of compensated cirrhosis.
- 4HCV-related disease progression is faster in patients who underwent transplantation in recent years compared with those who underwent transplantation earlier.
- 5HCV infection significantly impairs patient and allo-graft survival after liver transplantation.
- 6Several variables, including donor age, degree of immunosuppression, viral load either pretransplantation or early posttransplantation, timing of recurrence, and early histological findings, are implicated in the outcome of hepatitis C posttransplantation.