Posttransplantation prevention and treatment of recurrent hepatitis C.
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-alpha 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.
Burroughs
A K
AK
Department of Liver Transplantation, The Royal Free Hospital, London, UK. andrew.burroughs@talk21.com
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D065095:Calcineurin Inhibitors; D018450:Disease Progression; D004359:Drug Therapy, Combination; D019698:Hepatitis C, Chronic / Q000503:physiopathology / Q000517:prevention & control* / Q000601:surgery / Q000628:therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016031:Liver Transplantation; D012008:Recurrence; D013256:Steroids
D000893:Anti-Inflammatory Agents; D000998:Antiviral Agents; D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents; D013256:Steroids