title: New insights in recurrent HCV infection after liver transplantation.
abstract: Hepatitis C virus (HCV) is a small-enveloped RNA virus belonging to the Flaviviridae family. Since first identified in 1989, HCV has been estimated to infect 170 million people worldwide. Mostly chronic hepatitis C virus has a uniform natural history, from liver cirrhosis to the development of hepatocellular carcinoma. The current therapy for HCV infection consists of a combination of Pegylated interferon and ribavirin. On the other hand, HCV-related liver disease is also the leading indication for liver transplantation. However, posttransplant HCV re-infection of the graft has been reported to be universal. Furthermore, the graft after HCV re-infection often results in accelerated progression to liver failure. In addition, treatment of recurrent HCV infection after liver transplantation is often compromised by enhanced adverse effects and limited efficacy of interferon-based therapies. Taken together, poor outcome after HCV re-infection, regardless of grafts or recipients, poses a major issue for the hepatologists and transplant surgeons. The aim of this paper is to review several specific aspects regarding HCV re-infection after transplant: risk factors, current therapeutics for HCV in different stages of liver transplantation, cellular function of HCV proteins, and molecular mechanisms of HCV entry. Hopefully, this paper will inspire new strategies and novel inhibitors against recurrent HCV infection after liver transplantation and greatly improve its overall outcome.
authors.affiliation: Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Shih-Hsien
authors.initials: SH
authors.lastname: Hsu
authors.forename: Ming-Lun
authors.initials: ML
authors.lastname: Yeh
authors.forename: Shen-Nien
authors.initials: SN
authors.lastname: Wang
mesh_terms: D057134:Antibodies, Neutralizing / Q000627:therapeutic use*; D000998:Antiviral Agents / Q000627:therapeutic use; D005938:Glucocorticoids / Q000627:therapeutic use; D016174:Hepacivirus / Q000502:physiology*; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy / Q000473:pathology / Q000821:virology*; D022781:Hepatocytes / Q000821:virology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016898:Interferon-alpha / Q000627:therapeutic use; D017093:Liver Failure / Q000188:drug therapy / Q000209:etiology / Q000473:pathology / Q000821:virology*; D016031:Liver Transplantation; D011092:Polyethylene Glycols / Q000627:therapeutic use; D011994:Recombinant Proteins / Q000627:therapeutic use; D012008:Recurrence; D012254:Ribavirin / Q000627:therapeutic use; D012307:Risk Factors; D014759:Viral Envelope Proteins / Q000037:antagonists & inhibitors / Q000235:genetics / Q000378:metabolism; D053586:Virus Internalization
chemical_list: D057134:Antibodies, Neutralizing; D000998:Antiviral Agents; D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D016898:Interferon-alpha; D011994:Recombinant Proteins; D014759:Viral Envelope Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a