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World J Gastroenterol. Aug 28, 2014; 20(32): 11069-11079
Published online Aug 28, 2014. doi: 10.3748/wjg.v20.i32.11069
Natural history, treatment and prevention of hepatitis C recurrence after liver transplantation: Past, present and future
Jérôme Dumortier, Olivier Boillot, Jean-Yves Scoazec
Jérôme Dumortier, Olivier Boillot, Unité de Transplantation Hépatique-Fédération des Spécialités Digestives, HCL, Hôpital Edouard Herriot, 69437 Lyon, France
Jérôme Dumortier, Olivier Boillot, Jean-Yves Scoazec, Université Claude Bernard Lyon 1, 69437 Lyon, France
Jean-Yves Scoazec, Service d’Anatomie et Cytologie Pathologiques, HCL, Hôpital Edouard Herriot, 69437 Lyon, France
Correspondence to: Jérôme Dumortier, MD, PhD, Unité de Transplantation Hépatique-Fédération des Spécialités Digestives, HCL, Hôpital Edouard Herriot, Cedex 03, 69437 Lyon, France. jerome.dumortier@chu-lyon.fr
Telephone: +33-4-72110111 Fax: +33-4-72110147
Received: October 29, 2013
Revised: March 7, 2014
Accepted: June 20, 2014
Published online: August 28, 2014
Abstract

Hepatitis C virus (HCV)-related liver disease, including cirrhosis and hepatocellular carcinoma is the main indication for liver transplantation (LT) worldwide. Post-transplant HCV re-infection is almost universal and results in accelerated progression from acute hepatitis to chronic hepatitis, and liver cirrhosis. Comprehension and treatment of recurrent HCV infection after LT have been major issues for all transplant hepatologists and transplant surgeons for the last decades. The aim of this paper is to review the evolution of our knowledge on the natural history of HCV recurrence after LT, including risk factors for disease progression, and antiviral therapy. We will focus our attention on possible ways (present and future) to improve the final long-term results of LT for HCV-related liver disease.

Keywords: Hepatitis C, Liver transplantation, Recurrence, Fibrosis, Treatment

Core tip: This paper reviews the evolution of our knowledge on the natural history of hepatitis C virus (HCV) recurrence after liver transplantation, including risk factors for disease progression, and antiviral therapy. It is necessary to define an innovative public health policy to improve HCV screening which is the only way of allowing non-tested HCV patients access to therapy before they develop advanced liver disease.