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Related Concept Videos

Hepatitis01:25

Hepatitis

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Hepatitis is an inflammatory condition of the liver most commonly caused by hepatotropic viruses (A–E), though non-infectious causes such as alcohol and drugs also exist.Hepatitis AHepatitis A virus (HAV) is a non-enveloped RNA virus of the Picornaviridae family. It is primarily transmitted via the fecal-oral route, typically through ingestion of contaminated food or water. After ingestion, HAV enters the bloodstream through the oropharynx or intestinal epithelium and reaches the liver.
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Viral Hepatitis I: Introduction01:28

Viral Hepatitis I: Introduction

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Viral hepatitis is an inflammatory condition of the liver caused by infection with hepatotropic viruses, most commonly hepatitis A, B, C, D, and E. Despite variations in structure and transmission, all viruses mentioned infect hepatocytes and provoke immune responses that can hinder liver function. Additionally, some non-hepatotropic viruses can also lead to hepatic inflammation.Hepatitis A VirusHepatitis A virus (HAV) is transmitted through the fecal–oral route, typically by ingestion...
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Cytomegalovirus Disease01:27

Cytomegalovirus Disease

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Cytomegalovirus (CMV) disease is caused by human cytomegalovirus, a double-stranded DNA virus of the Herpesviridae family. While primary CMV infection is often asymptomatic in immunocompetent individuals, the virus can cause severe disease in neonates and immunocompromised patients. CMV is the most common cause of congenital viral infection in the United States, and a major pathogen in solid organ and hematopoietic stem cell transplant recipients.CMV is transmitted via bodily fluids, sexual...
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Kidney Transplant II: Surgical Procedure01:26

Kidney Transplant II: Surgical Procedure

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Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
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Liver Regeneration01:24

Liver Regeneration

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The liver is an important organ in vertebrates that plays an essential role in metabolism. It is also responsible for storing and redistributing nutrients such as carbohydrates, fats, and vitamins in the body. Additionally, the liver releases bile salts which are critical for digesting food and eliminating toxic metabolites from the body.
Cells of Liver
The liver comprises four major types of cells— hepatocytes, stellate, Kupffer, and sinusoidal endothelial cells. The hepatocytes are...
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Recurrent hepatitis C after liver transplant.

Andrew S deLemos1, Paul A Schmeltzer1, Mark W Russo1

  • 1Andrew S deLemos, Paul A Schmeltzer, Mark W Russo, Department of Medicine, Center for Liver Diseases and Transplantation, Carolinas Medical Center, Charlotte, NC 28232-2861, United States.

World Journal of Gastroenterology
|August 26, 2014
PubMed
Summary

Hepatitis C is a leading cause of liver transplants. New direct-acting antiviral agents offer hope for treating recurrent hepatitis C after liver transplantation, overcoming challenges with older therapies.

Keywords:
Acute cellular rejectionCytomegalovirusDonor risk factorsFibrosing cholestatic hepatitis CHepatitis CImmunosuppressionLiver transplantProtease inhibitors

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Area of Science:

  • Hepatology
  • Transplantation Immunology
  • Virology

Background:

  • Hepatitis C virus (HCV) infection is a primary driver for liver transplantation globally, representing up to 40% of procedures.
  • Antiviral treatments for HCV pre- or post-transplant are complicated by side effects, reduced efficacy in cirrhotic patients and transplant recipients, and drug interactions with immunosuppressants.

Purpose of the Study:

  • To review the challenges and advancements in managing hepatitis C in liver transplant recipients.
  • To highlight the impact of factors like donor age and immunosuppression on recurrent hepatitis C.
  • To discuss the potential of novel direct-acting antiviral agents.

Main Methods:

  • Literature review of studies on hepatitis C recurrence post-liver transplantation.
  • Analysis of factors influencing HCV recurrence, including donor age, immunosuppression, IL28B genotype, cytomegalovirus, and metabolic syndrome.
  • Evaluation of diagnostic challenges distinguishing recurrent hepatitis C from acute cellular rejection.
  • Assessment of emerging interferon-free direct-acting antiviral regimens.

Main Results:

  • Older donor age is a significant risk factor for recurrent hepatitis C after liver transplantation.
  • Differentiating recurrent hepatitis C from acute cellular rejection can be challenging, necessitating improved diagnostic tools.
  • Direct-acting antiviral agents (DAAs) targeting NS3/4A protease, NS5B polymerase, and NS5A show promise.

Conclusions:

  • Recurrent hepatitis C remains a significant concern following liver transplantation.
  • Donor age is a critical factor influencing HCV recurrence.
  • Interferon-free direct-acting antiviral regimens represent a promising therapeutic advance for liver transplant candidates and recipients with hepatitis C.