Abstract:
:Hepatitis C virus (HCV) infection is estimated to affect 130-150 million people globally which corresponds to 2%-3% of the total world population. It remains the leading indication for liver transplant worldwide and has been demonstrated to negatively impact both patient and graft survival following non-hepatic organ transplantation. In the era of interferon-based therapy, although treatment and cure of HCV prior to non-hepatic transplant improved survival, tolerability and low cure rates substantially limited therapy. Interferon (IFN)-based therapy following non-hepatic solid organ transplant, due to the risk of allograft rejection, is generally contraindicated. Rapid advances in IFN-free therapy with direct acting antivirals (DAAs) in the last few years have completely changed the paradigm of hepatitis C therapy. Compared to IFN-based regimens, DAAs have less frequent and less severe adverse effects, shorter durations of therapy, and higher cure rates that are minimally impacted by historically negative predictors of response such as cirrhosis, ethnicity, and post-transplant state. Recent studies have shown that liver transplant (LT) recipients can be safely and effectively treated with DAA combination therapies; although data are limited, many of the principles of therapy in LT may be extrapolated to non-hepatic solid organ transplant recipients. Here we review the data on DAA combination therapies in transplantation, discuss the advantages and disadvantages of pre- vs post-transplant HCV therapy and future directions.
journal_name
World J Gastroenteroljournal_title
World journal of gastroenterologyauthors
Belga S,Doucette KEdoi
10.3748/wjg.v22.i4.1650subject
Has Abstractpub_date
2016-01-28 00:00:00pages
1650-63issue
4eissn
1007-9327issn
2219-2840journal_volume
22pub_type
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pub_type: 杂志文章
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journal_title:World journal of gastroenterology
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journal_title:World journal of gastroenterology
pub_type: 杂志文章
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更新日期:2020-06-28 00:00:00
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