title: Liver transplantation for hepatitis C virus in the era of direct-acting antiviral agents.
abstract: Liver transplantation is widely used to treat HIV patients with an end-stage liver disease, mainly decompensated cirrhosis and hepatocellular carcinoma. The results are good especially in non-hepatitis C virus (HCV)-coinfected patients. In HIV-HCV-coinfected patients, 5-year post-liver transplantation survival is around 50-55%, negatively impacted by HCV recurrence. The results of PEG-IFN/RBV are poor in terms of efficacy and safety. In patients with genotype 1 infection, triple therapy (boceprevir or telaprevir) has increased sustained virological response (SVR) rate, but drug-drug interactions (DDIs) with immunosuppressive agents and high rates of adverse events lead to forsake these combinations. Herein, we provide new data and practical management regarding HIV-HCV liver transplantation patients using new direct-acting antiviral agents (DAA).
  
  
  
  The second-generation DAA have good safety profile. In patients who are candidates for liver transplantation or are already recipients, the optimal therapeutic option is to combine the new DAA. Efficacy results have dramatically improved with greater than 90% of SVR rate in many studies enrolling HCV-monoinfected liver transplant recipients. Some concerns persist in terms of DDI.
  
  
  
  Even sparse, data regarding efficacy and safety of these regimens in HCV-HIV-coinfected liver transplantation will radically change the prognosis of this peculiar population.
authors.affiliation: aAP-HP Hôpital Paul Brousse, Centre Hepato-Biliaire, Villejuif, France bDepartment of Infectious Diseases, Hepatology Outpatients Unit, University of Pavia - Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
authors.forename: Audrey
authors.initials: A
authors.lastname: Coilly
authors.forename: Raffaele
authors.initials: R
authors.lastname: Bruno
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D015658:HIV Infections / Q000150:complications*; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000601:surgery*; D006801:Humans; D016031:Liver Transplantation; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents