Topic Highlight
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 14, 2015; 21(38): 10760-10775
Published online Oct 14, 2015. doi: 10.3748/wjg.v21.i38.10760
Impact of new treatment options for hepatitis C virus infection in liver transplantation
Elda Righi, Angela Londero, Alessia Carnelutti, Umberto Baccarani, Matteo Bassetti
Elda Righi, Angela Londero, Alessia Carnelutti, Matteo Bassetti, Infectious Diseases Division, Santa Maria della Misericordia University Hospital, 33100 Udine, Italy
Umberto Baccarani, Liver Transplant Unit, Santa Maria della Misericordia University Hospital, 33100 Udine, Italy
Author contributions: Righi E analyzed the literature and wrote the manuscript; Baccarani U, Carnelutti A, Londero A and Bassetti M reviewed the literature.
Conflict-of-interest statement: The authors have no conflict of interest to report.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Elda Righi, MD, PhD, Infectious Diseases Division, Santa Maria della Misericordia University Hospital, 50 Colugna Street, 33100 Udine, Italy. elda.righi@libero.it
Telephone: +39-0432-559355 Fax: +39-0432-559360
Received: April 30, 2015
Peer-review started: May 7, 2015
First decision: June 23, 2015
Revised: July 12, 2015
Accepted: September 15, 2015
Article in press: September 15, 2015
Published online: October 14, 2015
Abstract

Liver transplant candidates and recipients with hepatitis C virus (HCV)-related liver disease greatly benefit from an effective antiviral therapy. The achievement of a sustained virological response before transplantation can prevent the recurrence of post-transplant HCV disease that occurs universally and correlates with enhanced progression to graft cirrhosis. Previous standard-of-care regimens (e.g., pegylated-interferon plus ribavirin with or without first generation protease inhibitors, boceprevir and telaprevir) displayed suboptimal results and poor tolerance in liver transplant recipients. A new class of potent direct-acting antiviral agents (DAA) characterized by all-oral regimens with minimal side effects has been approved and included in the recent guidelines for the treatment of liver transplant recipients with recurrent HCV disease. Association of sofosbuvir with ribavirin and/or ledipasvir is recommended in liver transplant recipients and patients with decompensated cirrhosis. Other regimens include simeprevir, daclatasvir, and combination of other DAA. Possible interactions should be monitored, especially in coinfected human immunodeficiency virus/HCV patients receiving antiretrovirals.

Keywords: Hepatitis C virus, Direct antiviral agents, Liver transplantation

Core tip: Until recently, a well-tolerated and effective treatment protocol to address the recurrence of hepatitis C virus (HCV) infection following liver transplantation has been an important unmet clinical need. Safe and effective treatment options are now available thanks to the approval of new classes of direct antiviral agents. The aim of this review was to summarize the outcome of previous treatments and discuss the impact of current options for the treatment of HCV among liver transplantation candidates and recipients, including coinfected human immunodeficiency virus/HCV patients.