Natural history of recurrent hepatitis C


  • Marina Berenguer

    Corresponding author
    1. Hepato-Gastroenterology Service, La Fe Hospital, Valencia, Spain
    • Hospital Universitario La Fe, Servicio de Medicina Digestiva, Avda Campanar 21, 46009 Valencia, Spain. Telephone: 34-96-386-8792; FAX: 34-96-197-3118
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  • 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.