Hepatic Transplant and HCV: A New Playground for an Old Virus

Abstract

Hepatitis C virus (HCV) infection is a major globalhealth problem affecting 170 million people worldwide. The majority of infected individuals fail to resolve their infection, with a significant number developing chronic, progressive HCV-related liver disease. HCV infection is the leading indication for liver transplantation and unfortunately, all patients with detectable viral load before transplantation will have rapid, recurrent infection. What remain to be determined are factors contributing to the severity of HCV recurrence. Such factors are unique to the posttransplant setting and include: viral genetic diversity and composition, immunosuppression, donor/recipient age and sex, genetic factors and the liver microenvironment. Importantly, the possibility that the severity of HCV recurrence might be also influenced by factors related to the primary course of disease (i.e. viral set point, previously acquired adaptations of the virus) must be further evaluated. In this sense, recurrent HCV infection should not be regarded merely as another acute infection, but rather, it should be cautioned that problems first arising during the primary course of disease may be accentuated during recurrence. Development of novel therapeutic approaches will require a thorough understanding of viral and host determinants of infection resolution and how these factors may change in the posttransplant setting.

MicroRNAs and liver disease: viral hepatitis, liver fibrosis and hepatocellular carcinoma

“…HCV infection is believed to account for 40% of chronic liver disease and remains the major reason for liver transplantation 16. About 3% of the global population is infected with HCV 17. In the patient with chronic HCV who undergoes transplantation, reinfection of the liver will ultimately result in fibrosis that will further disease progression.…”

Significant Infections After Hand Transplantation in a Polish Population

“…Some of them suffer from chronic infections in the pretransplantation period (eg, hepatitis C virus in liver recipients and bacterial respiratory tract infection in lung recipients) [2,3]. Not only previous contagion but also intense immunosuppression facilitates bacterial, fungal, and viral infections after transplantation.…”

Direct-Acting Antiviral Agents for Hepatitis C Virus Infection

“…Although rates of new infection have declined in developed countries, infections from prior decades will continue to place a substantial burden on our healthcare system. There are approximately 350,000 HCV-related deaths annually (2), and HCV is the leading indication for liver transplantation (4). …”