*Recipient of a scholarship from CAPES/Brazil.
Therapeutic management of recurrent hepatitis C after liver transplantation
Article first published online: 26 JAN 2007
Volume 27, Issue 3, pages 302–312, April 2007
How to Cite
Teixeira, R., Godinho Menezes, É. and Schiano, T. D. (2007), Therapeutic management of recurrent hepatitis C after liver transplantation. Liver International, 27: 302–312. doi: 10.1111/j.1478-3231.2006.01426.x
- Issue published online: 26 JAN 2007
- Article first published online: 26 JAN 2007
- Received 17 July 2006accepted 3 December 2006
- hepatitis C recurrence;
- liver transplantation;
Recurrent hepatitis C ranges from minimal damage to cirrhosis developing in a few months or years in a substantial proportion of transplant recipients. Different virus, host and donor factors are involved in the pathogenesis of recurrence, but many are poorly understood. Therapeutic strategies can be utilized in the pre-, peri- or posttransplantation setting. Antiviral therapy using interferon and ribavirin and modifying immunosuppression are the main strategies to prevent progression disease. The efficacy of interferon and ribavirin is limited and side effects, reduction/withdrawal are frequent. Current sustained virological response rates are approximately 28%. An optimal immunosupppression regimen has not been established. The choice of calcineurin inhibitors has not clearly been shown to affect histological hepatitis C virus (HCV) but higher cumulative exposure to corticosteroids to treat acute rejection is associated with more severe recurrence. The manner in which the doses of immunosuppression are modified has more influence on HCV recurrence than the use of a specific drug per se. Debate about the influence of immunosuppressive regimens on HCV recurrence is ongoing. Potential antifibrotic therapy and new agents targeting HCV infection and replication are emerging and are anticipated to be added to our armentarium in battling recurrent HCV post-LT.