Natural History and Treatment of Hepatitis C in Liver Transplant Recipients

Hepatitis C is not cured with liver transplantation. Patients with hepatitis C virus (HCV) infection have reduced graft and patient survivals compared with non-HCV patients following liver transplantation. Both HCV recurrence and fibrosis are accelerated under the influence of transplantation and immunosuppression. Antiviral therapy has been shown to reduce fibrosis progression and graft loss. The goal of therapy is sustained virologic response and reduction of damage. However, the optimal timing and treatment regimen for patients with HCV following transplant is unclear. Following transplant, sustained virologic response rates are reduced and patient tolerance is limited. Improved treatment strategies are needed to reduce patient side effects and increase efficacy in this population of patients.