Managing HBV and HCV Infection Pre- and Post-liver Transplant

Area of Science:

• Hepatology
• Virology
• Transplantation Medicine

Background:

• Hepatitis B (HBV) and Hepatitis C (HCV) are primary drivers of end-stage liver disease and liver transplant indications.
• Preventing post-transplant HBV recurrence is crucial for long-term outcomes.

Purpose of the Study:

• To review current treatment strategies for HBV and HCV infections in liver transplant candidates and recipients.
• To highlight the evolution of antiviral therapies and their impact on patient management.

Main Methods:

• Review of existing literature on HBV and HCV treatment protocols.
• Discussion of nucleos(t)ide analogs for HBV and direct-acting antivirals for HCV.
• Analysis of treatment timing relative to liver transplantation.

Main Results:

• Nucleos(t)ide analogs are standard for HBV management pre- and post-transplant.
• Direct-acting antivirals have revolutionized HCV treatment, achieving high sustained virological response rates (up to 90%).
• For advanced HCV cirrhosis, transplantation followed by antiviral treatment is often preferred.

Conclusions:

• Effective antiviral therapies significantly improve outcomes for patients with HBV and HCV undergoing liver transplantation.
• Management strategies must be tailored based on the specific hepatitis virus and patient's clinical status.