title: News and challenges in the treatment of hepatitis C in liver transplantation.
abstract: Hepatitis C virus (HCV) infection is one of the main causes of end-stage liver disease and indications for liver transplantation (LT) worldwide. HCV infection always recurs on the graft in patients who undergo LT with detectable serum HCV RNA, leading to cirrhosis in 20-30% within 5 years after transplantation. Achieving a sustained virological response (SVR) greatly improves patient and graft survival. Recently, the efficacy of therapy has radically changed and improved based on new direct acting antiviral agents (DAAs) without pegylated-interferon (PEG-IFN) and/or ribavirin (RBV), leading to SVR rates of more than 90% in transplanted patients. The safety profile in this population is also good, with limited drug-drug interactions. However, there are very few data on patients on the waiting list. Even when the results of combined DAAs are good (>80%), SVR rates are lower than in patients without cirrhosis. This review reports recent available data on the treatment of HCV infection in the transplant setting and discusses new dilemmas and challenges.
authors.affiliation: AP-HP Hôpital Paul Brousse, Centre Hépato-Biliaire, Villejuif, F-94800, France.|Univ. Paris-Sud, Univ. Paris-Saclay, Villejuif, F-94800, France.|Unité 1193, Inserm, Villejuif, F-94800, France.|Hepatinov, Villejuif, F-94800, France.
authors.forename: Audrey
authors.initials: A
authors.lastname: Coilly
authors.affiliation: AP-HP Hôpital Paul Brousse, Centre Hépato-Biliaire, Villejuif, F-94800, France.|Unité 1193, Inserm, Villejuif, F-94800, France.|Hepatinov, Villejuif, F-94800, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Roche
authors.affiliation: AP-HP Hôpital Paul Brousse, Centre Hépato-Biliaire, Villejuif, F-94800, France.|Univ. Paris-Sud, Univ. Paris-Saclay, Villejuif, F-94800, France.|Unité 1193, Inserm, Villejuif, F-94800, France.|Hepatinov, Villejuif, F-94800, France.
authors.forename: Jean-Charles
authors.initials: JC
authors.lastname: Duclos-Vallée
authors.affiliation: AP-HP Hôpital Paul Brousse, Centre Hépato-Biliaire, Villejuif, F-94800, France.|Univ. Paris-Sud, Univ. Paris-Saclay, Villejuif, F-94800, France.|Unité 1193, Inserm, Villejuif, F-94800, France.|Hepatinov, Villejuif, F-94800, France.
authors.forename: Didier
authors.initials: D
authors.lastname: Samuel
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D058625:End Stage Liver Disease / Q000209:etiology* / Q000601:surgery*; D016174:Hepacivirus / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use; D008103:Liver Cirrhosis / Q000209:etiology; D016031:Liver Transplantation / Q000009:adverse effects*; D012008:Recurrence; D012254:Ribavirin / Q000627:therapeutic use
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D012254:Ribavirin
keywords: antiviral therapy; decompensated cirrhosis; direct acting antivirals; drug-drug interactions; hepatitis C; liver transplantation