Management of HCV in the liver transplant setting

Berenguer, Marina

doi:10.1016/j.clinre.2015.05.004

Cited by 5 publications

(9 citation statements)

References 28 publications

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“…Data from clinical trials and real-life settings will provide information to assess the impact of therapy in the DAA era and the role of ribavirin nowadays (11). Especially for OLT recipients, these new drugs bring renewed hope, since the use of interferon and ribavirin in the post-transplantation population is associated with lower SVR rates and high rates of adverse events, such as anemia and neutropenia.…”

Section: Discussionmentioning

confidence: 99%

“…The virological efficacy of HCV therapeutic options has improved drastically over recent years, from 30% success rate with interferon-based therapies to around 90% with interferon-free direct acting antiviral agents (DAAs) (11). However, regardless of the medication used, the objectives of HCV treatment have not changed: to prevent progression to cirrhosis and loss of the graft (12 –20).…”

Section: Introductionmentioning

confidence: 99%

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Survival benefits of interferon-based therapy in patients with recurrent hepatitis C after orthotopic liver transplantation

Zanaga

Vigani

Angerami

et al. 2017

Braz J Med Biol Res

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Recurrent hepatitis C after orthotopic liver transplantation (OLT) is universal and can lead to graft failure and, consequently, reduced survival. Hepatitis C treatment can be used to prevent these detrimental outcomes. The aim of this study was to describe rates of hepatitis C recurrence and sustained virological response (SVR) to interferon-based treatment after OLT and its relationship to survival and progression of liver disease through retrospective analysis of medical records of 127 patients who underwent OLT due to cirrhosis or hepatocellular carcinoma secondary to chronic hepatitis C between January 2002 and December 2013. Fifty-six patients were diagnosed with recurrent disease, 42 started interferon-based therapy and 37 completed treatment. Demographic, treatment- and outcome-related variables were compared between SVR and non-responders (non-SVR). There was an overall 54.1% SVR rate with interferon-based therapies. SVR was associated with longer follow-up after treatment (median 66.5 vs 37 months for non-SVR, P=0.03) and after OLT (median 105 vs 72 months, P=0.074), and lower rates of disease progression (15 vs 64.7%, P=0.0028) and death (5 vs 35.3%, P=0.033). Regardless of the result of therapy (SVR or non-SVR), there was a significant difference between treated and untreated patients regarding the occurrence of death (P<0.001) and months of survival (P<0.001). Even with suboptimal interferon-based therapies (compared to the new direct-acting antivirals) there is a 54.1% SVR rate to treatment. SVR is associated with improved survival and reduced risks of clinical decompensation, loss of the liver graft and death.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Survival benefits of interferon-based therapy in patients with recurrent hepatitis C after orthotopic liver transplantation

Zanaga

Vigani

Angerami

et al. 2017

Braz J Med Biol Res

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“…It is estimated that the prevalence of liver cirrhosis in untreated patients with chronic HCV will increase from 25% in 2010, to 45% in 2030 . HCV‐related liver cirrhosis remains the main indication for liver transplantation in developed countries . Chronic HCV infection is also associated with various extra‐hepatic manifestations …”

Section: Introductionmentioning

confidence: 99%

Review article: treatment as prevention – targeting people who inject drugs as a pathway towards hepatitis C eradication

Leask

Dillon

2016

Aliment Pharmacol Ther

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Summary Background Hepatitis C virus (HCV) is a leading cause of chronic liver disease worldwide. HCV predominates in people who inject drugs; a group in whom anti‐viral therapy has previously been withheld on the basis of chaotic lifestyles and associated risks of reinfection. New research has emerged which suggests that by specifically targeting HCV‐infected people who inject drugs for treatment, the pool of HCV would deplete, thus reducing overall transmission and eventually leading to HCV eradication. Aim To outline the requirements for HCV eradication and review the evidence that this is achievable. Methods Expert review of the literature. Results The achievement of HCV eradication using ‘treatment as prevention’ is supported by numerous epidemiological modelling studies employing a variety of models in several contexts including people who inject drugs, men who have sex with men and prisoners. More recent studies also incorporate the newer, more efficacious direct‐acting anti‐viral drugs. These drugs have been shown to be safe and effective in people who inject drugs in clinical trials. There is no empirical evidence of the impact of treatment as prevention strategies on population prevalence. Conclusions This review highlights the efforts to control HCV and evaluates the possibilities of achieving eradication of HCV. Currently, the technologies required to achieve HCV eradication exist, but the infrastructure to deliver them is not generally available or of insufficient scale outside of specific areas. Such areas are yet to demonstrate that elimination is possible, but results of studies in these areas are awaited. Such a demonstration would be proof of principle for eradication. Although we are aspiring towards HCV eradication, elimination is the more realistic prospect.

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“…No specific morphologic findings are identified in BMs in nonhepatitis C patients with LT. Recurrence of HCV infection remains a major problem in patients with LT . Hepatitis C virus can infect BM hematopoietic stem cells, circulating lymphocytes, and monocytes, which could serve as viral reservoirs.…”

Section: Discussionmentioning

confidence: 99%

Spectrum of bone marrow morphologic findings in hepatitis C patients with and without prior liver transplantation

Boone

Cui

2016

Int J Lab Hematology

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Management of HCV in the liver transplant setting

Cited by 5 publications

References 28 publications

Survival benefits of interferon-based therapy in patients with recurrent hepatitis C after orthotopic liver transplantation

Survival benefits of interferon-based therapy in patients with recurrent hepatitis C after orthotopic liver transplantation

Review article: treatment as prevention – targeting people who inject drugs as a pathway towards hepatitis C eradication

Spectrum of bone marrow morphologic findings in hepatitis C patients with and without prior liver transplantation

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