Details

Autor(en) / Beteiligte

• Berenguer, M.
• Agarwal, K.
• Burra, P.
• Manns, M.
• Samuel, D.

Titel

The road map toward an hepatitis C virus‐free transplant population

Ist Teil von

• American journal of transplantation, 2018-10, Vol.18 (10), p.2409-2416

Ort / Verlag

United States: Wiley Subscription Services, Inc

Erscheinungsjahr

2018

Quelle

Free E-Journal (出版社公開部分のみ）

Beschreibungen/Notizen

• Antiviral therapy to eradicate hepatitis C virus (HCV) infection improves outcomes in patients undergoing liver transplantation (LT) for advanced chronic HCV with or without hepatocellular carcinoma. Traditionally, antiviral therapy focused on the use of interferon (IFN)‐based regimens, with antiviral treatment initiated in the posttransplant period once recurrent HCV disease with fibrosis in the allograft was identified. The use of IFN‐based therapy was limited in pretransplant patients with advanced liver disease. Earlier intervention, either before transplantation or early after LT, is now feasible with the advent of second‐generation direct‐acting antiviral agents (DAAs) with superior tolerability and efficacy to IFN‐based therapy. These agents have the potential to reduce the number of patients developing HCV‐related complications requiring LT and retransplantation, as well as reducing the demand for donor organs. We discuss the pros and cons of pretransplant, peritransplant, and posttransplant therapy with current DAAs, citing available data from clinical trials and real‐world experience. This article considers the optimal use of direct‐acting antiviral agents for patients with HCV pre–, peri–, and post–liver transplant and provides expert opinion on current controversies and clinical issues that remain to be addressed.