Treatment of hepatitis B and C after liver transplantation. Part 2, hepatitis C

Area of Science:

• Hepatology
• Transplantation Immunology
• Virology

Background:

• Hepatitis C virus (HCV) infection is a leading cause of end-stage liver disease and liver transplantation.
• Graft re-infection with HCV post-transplantation is common and significantly reduces patient and graft survival.
• Factors influencing HCV graft injury severity and progression are not well understood.

Purpose of the Study:

• To review the impact of HCV recurrence on liver transplant outcomes.
• To evaluate current and emerging antiviral treatment strategies for HCV in liver transplant recipients.
• To identify areas for future research regarding HCV graft injury management.

Main Methods:

• Literature review of studies on HCV recurrence after liver transplantation.
• Analysis of data on the efficacy and safety of antiviral treatments (single-agent and combination therapy).
• Discussion of factors affecting disease progression and treatment outcomes.

Main Results:

• HCV re-infection is nearly universal post-transplant and negatively impacts survival.
• Single-agent therapies (interferon, ribavirin) for established graft lesions have shown limited success.
• Combination antiviral therapy has yielded promising results, achieving sustained virological response in 25% of patients.

Conclusions:

• HCV recurrence remains a critical challenge in liver transplantation.
• Combination antiviral therapy offers a potential treatment option for HCV graft lesions.
• Further research is needed to define optimal indications, modalities, and duration for post-transplant antiviral treatment.