Hepatitis B and C in the liver transplant recipient: current understanding and treatment.
1. Liver disease related to chronic viral hepatitis is the leading indication for orthotopic liver transplantation (OLT) worldwide. 2. The natural history of hepatitis B virus infection has been dramatically modified, and outcome has improved substantially in the last decade with the use of hepatitis B immunoglobulin and lamivudine. 3. Hepatitis C virus (HCV) recurrence, defined by histological injury, is almost universal, and a subset of patients (20% to 30%) develops allograft cirrhosis by the fifth year post-OLT. 4. Unfortunately, antiviral therapy for hepatitis C post-OLT, even when initiated preemptively before the development of histological recurrence in the first few weeks post-OLT, has failed to alter the natural history of HCV disease recurrence. 5. HCV-related allograft cirrhosis is associated with a high rate of decompensation and mortality.
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Division of Gastroenterology/Hepatology and Liver Transplantation Program, Portland Veterans Administration and Oregon Health Sciences University, Portland, OR 97207, USA. hugo.rosen@med.va.gov
D004359:Drug Therapy, Combination; D006509:Hepatitis B / Q000175:diagnosis / Q000517:prevention & control / Q000601:surgery* / Q000628:therapy; D006526:Hepatitis C / Q000517:prevention & control / Q000601:surgery* / Q000628:therapy; D006801:Humans; D007136:Immunoglobulins / Q000627:therapeutic use; D016031:Liver Transplantation; D009705:Nucleosides / Q000627:therapeutic use; D012086:Reoperation; D055502:Secondary Prevention
D007136:Immunoglobulins; D009705:Nucleosides; C045213:hepatitis B hyperimmune globulin