Treatment of hepatitis C virus reinfection after liver transplantation

Most liver transplant recipients become reinfected with hepatitis C virus after OLT followed by allograft dysfunction, transplant cirrhosis and graft failure in a significant proportion of patients. Both in the pre-emptive prophylactic setting and in the treatment setting sustained virological response rates are poor compared to the precirrhotic hepatitis state. Patients with significant hepatitis should be always treated before developing cirrhosis or even with early cirrhosis. After transplantation pegylated interferon in combination with ribavirin is the most successful treatment opportunity to date, however the best time point and treatment duration as well as doses for pegylated interferons and rebavirin have to be defined.