HCV Antiviral Therapy in Liver Transplant Candidates and Recipients With Renal Insufficiency.

Abstract:

:Hepatitis C virus (HCV) remains the leading indication for liver transplant in much of the world and has traditionally been associated with diminished posttransplant survival due to recurrent HCV-related liver disease. This field has been dramatically changed by the advent of safe and effective direct-acting antiviral therapy, such that most patients can be cured in the pretransplant or posttransplant setting. In addition, there are now direct-acting antiviral regimens specifically approved for use in patients with severe renal insufficiency. However, patients with pre or posttransplant severe renal insufficiency remain more difficult to treat, due to mechanisms of drug metabolism in hepatic and renal failure, as well as posttransplant drug-drug interactions. Treatment options are even more restricted in non-1 HCV genotypes. Because renal insufficiency is common among patients with HCV, with decompensated cirrhosis, and in the posttransplant setting, this difficult scenario is relatively common. However, ongoing development of pangenotypic regimens with improved safety profiles, as well as additional data on dosing and safety among patients with severe renal insufficiency, will continue to expand options for cure even in these most difficult to treat patients.

journal_name

Transplantation

journal_title

Transplantation

authors

Verna EC,Brown RS Jr

doi

10.1097/TP.0000000000001688

subject

Has Abstract

pub_date

2017-05-01 00:00:00

pages

924-932

issue

5

eissn

0041-1337

issn

1534-6080

journal_volume

101

pub_type

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