title: Hepatitis C: New challenges in liver transplantation.
abstract: In an era of great achievements in liver transplantation, hepatitis C viral infection (HCV) remains an unsolved problem. As a leading indication for liver transplantation in Western countries, HCV poses a significant burden both before and after transplantation. Post-transplant disease recurrence occurs in nearly all patients with detectable pretransplant viremia, compromising the lifesaving significance of transplantation. Many factors involving the donor, recipient and virus have been evaluated throughout the literature, although few have been fully elucidated and implemented in actual clinical practice. Antiviral therapy has been recognized as a cornerstone of HCV infection control; however, experience and success are diminished following transplantation in a challenging cohort of patients with liver cirrhosis. Current therapeutic protocols surpass those used previously, both in sustained viral response and side-effect profile. In this article we review the most relevant and contemporary scientific evidence regarding hepatitis C infection and liver transplantation, with special attention dedicated to novel, more efficient and safer antiviral regimens.
authors.affiliation: Tajana Filipec Kanizaj, Department of Gastroenterology, University Hospital Merkur, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia.
authors.forename: Tajana
authors.initials: T
authors.lastname: Filipec Kanizaj
authors.affiliation: Tajana Filipec Kanizaj, Department of Gastroenterology, University Hospital Merkur, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia.
authors.forename: Nino
authors.initials: N
authors.lastname: Kunac
mesh_terms: D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D058625:End Stage Liver Disease / Q000175:diagnosis / Q000401:mortality / Q000601:surgery* / Q000821:virology; D016174:Hepacivirus / Q000187:drug effects* / Q000254:growth & development; D006526:Hepatitis C / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects / Q000401:mortality; D012008:Recurrence; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014775:Virus Activation / Q000187:drug effects
chemical_list: D000998:Antiviral Agents
keywords: Direct acting antivirals; Hepatitis C; Liver transplantation; Pegylated interferon; Ribavirin; Treatment protocols