الفهرس 
: Hepatitis C VirusOnly 14 pages are availabe for public view
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Abstract
SUMMARY
Hepatitis C virus associated cirrhosis is the most common indication for liver transplantation. Recurrent HCV infection following orthotopic liver transplantation (OLT) remains a major cause of morbidity and mortality in the post-transplantation setting.
The clinical course following OLT for HCV infection is variable. As a general rule, the course of HCV infection appears to be accelerated compared with the pretransplant setting. Several patterns of recurrence have been described.
Many predictors of outcome following transplantation have been described, but their accuracy in predicting the course in individual patients or to guide interventions is uncertain. The use of older donors is likely associated with adverse outcomes.
The diagnosis of recurrent HCV infection is based upon the detection of HCV RNA, and compatible histologic characteristics.
Based on these scant preliminary results, it is difficult to offer any guidelines on the use of DAAs, mainly represented by TLV and BCV, in LT patients as the available data are neither consistent nor conclusive.
The goal of antiviral therapy is the achievement of a sustained virological response, and this confers a survival benefit.
The risks and benefits of triple therapy with protease inhibitors are to be determined.
Studies are needed regarding the efficacy and safety of directly acting antivirals (eg, boceprevir and telaprevir) in this setting. Therapy should be attempted only at centers with considerable experience in managing post-transplantation patients.
There is no evidence to support a survival benefit for therapy; thus, preemptive therapy is not currently supported by available data
The landscape of treatment for hepatitis C virus (HCV) infection has evolved substantially since the introduction of highly effective HCV protease inhibitor therapies in 2011. The pace of change is expected to increase rapidly, as numerous new drugs with different mechanisms of action will likely become available over the next few years.
Hard clinical data on the effects of these new potent HCV inhibitors in patients with post-LT recurrence of HCV infection are urgently needed.