Hepatitis C management in post-transplant patients.
Hepatitis C virus (HCV)-related cirrhosis is the leading cause for liver transplantation (LT) in developed countries. One of the most troubling complications following LT in patients with HCV is that of recurrence. Unfortunately, this occurs in nearly all patients with HCV. Patients suffering recurrence are known to have faster times to fibrosis and consequently higher rates of graft failure. In general, patients whom undergo transplantation for HCV cirrhosis have higher mortalities comparatively. It is for this reason that HCV in post-transplant patients must be strictly monitored for and treated. Until recently, treatment with standard therapy or pegylated interferon and ribavirin was only marginally effective and the use in this population was off-label. With the advent of direct acting antivirals (DAA), hopes for improved sustained virologic response (SVR) exists. This review will attempt to provide an update regarding recent data for HCV treatment in post-transplant patients, and by doing so, hopefully shed light on a previously dim and dreaded illness.
Department of Internal Medicine University of Florida College of Medicine Gainesville, FL, USA - Roberto.Firpi@medicine.ufl.edu.
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Firpi
D000998:Antiviral Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001562:Benzimidazoles / Q000627:therapeutic use; D002219:Carbamates; D004359:Drug Therapy, Combination; D005449:Fluorenes / Q000627:therapeutic use; D006526:Hepatitis C / Q000188:drug therapy*; D006575:Heterocyclic Compounds, 3-Ring / Q000627:therapeutic use; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use; D008103:Liver Cirrhosis / Q000601:surgery / Q000821:virology; D016031:Liver Transplantation / Q000009:adverse effects; D009842:Oligopeptides / Q000627:therapeutic use; D011092:Polyethylene Glycols / Q000627:therapeutic use; D011392:Proline / Q000031:analogs & derivatives / Q000627:therapeutic use; D011759:Pyrrolidines; D011994:Recombinant Proteins / Q000627:therapeutic use; D012008:Recurrence; D012254:Ribavirin / Q000627:therapeutic use; D012307:Risk Factors; D000069616:Simeprevir; D000069474:Sofosbuvir; D013449:Sulfonamides / Q000627:therapeutic use; D016896:Treatment Outcome; D014542:Uridine Monophosphate / Q000031:analogs & derivatives / Q000627:therapeutic use; D014633:Valine / Q000031:analogs & derivatives; D019562:Viral Load / Q000187:drug effects*
D000998:Antiviral Agents; D001562:Benzimidazoles; D002219:Carbamates; D005449:Fluorenes; D006575:Heterocyclic Compounds, 3-Ring; D007093:Imidazoles; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D009842:Oligopeptides; D011759:Pyrrolidines; D011994:Recombinant Proteins; D013449:Sulfonamides; C586541:ledipasvir; D011092:Polyethylene Glycols; D012254:Ribavirin; C486464:telaprevir; C512204:N-(3-amino-1-(cyclobutylmethyl)-2,3-dioxopropyl)-3-(2-((((1,1-dimethylethyl)amino)carbonyl)amino)-3,3-dimethyl-1-oxobutyl)-6,6-dimethyl-3-azabicyclo(3.1.0)hexan-2-carboxamide; D011392:Proline; D000069616:Simeprevir; D014542:Uridine Monophosphate; C417083:peginterferon alfa-2b; D014633:Valine; C549273:daclatasvir; C100416:peginterferon alfa-2a; D000069474:Sofosbuvir