title: Prophylaxis and treatment of recurrent viral hepatitis after liver transplantation.
abstract: Chronic hepatitis B or C can cause severe liver diseases such as liver cirrhosis and hepatocellular carcinoma (HCC). Both viral infections together especially hepatitis c virus infection (HCV) are the mayor indication for liver transplantation in Western Europe and the United States. Recurrence of hepatitis B virus (HBV) or HCV infection after orthotopic liver transplantation (OLT) plays a key role for the outcome after liver transplantation concerning patient and graft survival rates. Allograft dysfunctions, cirrhosis of the allograft and graft failure are major complications after recurrent viral hepatitis. The survival after liver transplantation for HBV-related liver disease changed dramatically during the last two decades with results today comparable with non-HBV-related liver transplantations. Availability of immunoprophylaxis with hepatitis B immunoglobulin (HBIG) as well as nucleoside/nucleotide analogues like lamivudine or adefovir in the pre- and post-transplant setting conferred to significant better results due to an efficient prophylaxis and the possibility of therapy of HBV reinfection of the allograft. New drugs such as entecavir, tenofovir and telbivudine for the treatment of chronic hepatitis B infections may offer even more opportunities in the transplant setting. In contrast, despite recent achievements in the treatment of HCV infection with pegylated interferons and ribavirin, patients with HCV cirrhosis or after liver transplantation are difficult to treat. Sustained virological response (SVR) rates in prophylactic and therapeutic approaches of HCV reinfection after OLT are only low compared to the pre-cirrhotic HCV infection. Moreover, best treatment duration and dosage of recurrent HCV infection with pegylated interferon in combination with ribavirin remains to be defined.
authors: University of Heidelberg, Department of Gastroenterology and Hepatology, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany. Carina_Riediger@med.uni-heidelberg.de
authors: Carina
authors: C
authors: Riediger
authors: Pascal O
authors: PO
authors: Berberat
authors: Peter
authors: P
authors: Sauer
authors: Daniel
authors: D
authors: Gotthardt
authors: Karl Heinz
authors: KH
authors: Weiss
authors: Arianeb
authors: A
authors: Mehrabi
authors: Uta
authors: U
authors: Merle
authors: Wolfgang
authors: W
authors: Stremmel
authors: Jens
authors: J
authors: Encke
mesh_terms: D000998:Antiviral Agents / Q000494:pharmacology; D005355:Fibrosis / Q000628:therapy / Q000821:virology; D019694:Hepatitis B, Chronic / Q000276:immunology; D006521:Hepatitis, Chronic / Q000175:diagnosis* / Q000517:prevention & control / Q000628:therapy / Q000821:virology*; D006801:Humans; D007136:Immunoglobulins / Q000737:chemistry; D007372:Interferons / Q000494:pharmacology; D016031:Liver Transplantation / Q000379:methods*; D011092:Polyethylene Glycols / Q000737:chemistry; D012008:Recurrence; D012254:Ribavirin / Q000494:pharmacology; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D007136:Immunoglobulins; D011092:Polyethylene Glycols; D012254:Ribavirin; D007372:Interferons