Please use this identifier to cite or link to this item: http://hdl.handle.net/20.500.12857/116253
Title: Hepatitis C virus and liver transplantation: where do we stand?
Authors: Burra, Patrizia 
De Martin, Eleonora 
Zanetto, Alberto 
Senzolo, Marco 
Russo, Francesco Paolo 
Zanus, Giacomo 
Fagiuoli, Stefano
Keywords: HCV recurrence;antiviral therapy;direct antiviral agents;liver fibrosis;liver transplantation
Keywords Plus: INTERFERON-ALPHA-2B PLUS RIBAVIRIN;FIBROSING CHOLESTATIC HEPATITIS;SUSTAINED VIROLOGICAL RESPONSE;STELLATE CELL ACTIVATION;DONOR GRAFT STEATOSIS;LIVING-DONOR;ANTIVIRAL THERAPY;DECEASED-DONOR;PEGYLATED INTERFERON-ALPHA-2B;HCV RECURRENCE
Mesh headings: Antiviral Agents;Hepatitis C;Liver Transplantation
Secondary Mesh headings: Hepacivirus;Humans;Immunosuppressive Agents;Liver Cirrhosis;RNA, Viral;Recurrence;Tissue Donors
Issue Date: Feb-2016
Publisher: WILEY
Journal: Transplant international : official journal of the European Society for Organ Transplantation 
Abstract: 
The hepatitis C virus (HCV) infects more than 180 million people globally, with increasing incidence, especially in developing countries. HCV infection frequently progresses to liver cirrhosis leading to liver transplantation or death, and HCV recurrence still constitutes a major challenge for the transplant team. Antiviral therapy is the only available instrument to slow down this process, although its actual impact on liver histology, in responders and nonresponders, is still controversial. We are now facing a "new era" of direct antiviral agents that is already changing the approach to HCV burden both in the pre- and in the post-liver transplantation settings. Available data on sofosbuvir/ledipasvir and sofosbuvir/simeprevir in patients with decompensated cirrhosis sustain a SVR12 of 89% , but one-third of patients do not clinically improved. The sofosbuvir/ribavirin treatment in stable cirrhotic patients with HCC before liver transplantation is associated with 2% recurrence rate if liver transplantation is performed at least one month after undetectable HCV-RNA is achieved. The treatment of recurrence with the new antiviral drugs is associated with a SVR that ranges between 60 and 90%. In this review, we have focused on the evolution of antiviral therapy for HCV recurrence from the "old" interferon-based therapy to the "new" interferon-free regimens, highlighting useful information to aid the transplant hepatologist in the clinical practice.
URI: http://hdl.handle.net/20.500.12857/116253
ISSN: 09340874
DOI: 10.1111/tri.12642
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