Management of viral hepatitis in liver transplant recipients

Clin Mol Hepatol. 2014 Dec;20(4):338-44. doi: 10.3350/cmh.2014.20.4.338. Epub 2014 Dec 24.

Abstract

Recurrence of viral hepatitis after liver transplantation (LT) can progress to graft failure and lead to a decrease in long-term survival. Recently, there have been remarkable improvement in the treatment of chronic hepatitis B (CHB) using potent antiviral agents. Combination of hepatitis B immunoglobulin and potent antiviral therapy has brought marked advances in the management of CHB for liver transplant recipients. Post-transplant antiviral therapy for hepatitis C virus infection is generally reserved for patients showing progressive disease. Acheiving a sustained virological response in patients with LT greatly ameliorates graft and overall survival, however this only occurs in 30% of transplant recipient using pegylated interferon and ribavirin (RBV). Direct acting antivirals such as protease inhibitors, polymerase or other non-structural proteins inhibitors are anticipated to establish the new standard of care for transplant recipients. In liver transplant recipients, hepatitis E virus infection is an uncommon disease. However, it can lead to chronic hepatitis and cirrhosis and may require retransplantation. Recently, 3-month course of RBV monotherapy has been reported as an effective treatment. This review focuses on the recent management and therapeutic approaches of viral hepatitis in liver transplant recipient.

Keywords: Antiviral therapy; Liver transplantation; Management; Recurrence; Viral hepatitis.

Publication types

  • Review

MeSH terms

  • Antiviral Agents / therapeutic use
  • Hepatitis B / drug therapy
  • Hepatitis B / pathology
  • Hepatitis B / surgery
  • Hepatitis C / drug therapy
  • Hepatitis C / pathology
  • Hepatitis C / surgery
  • Hepatitis E / drug therapy
  • Hepatitis E / pathology
  • Hepatitis E / surgery
  • Hepatitis, Viral, Human / drug therapy
  • Hepatitis, Viral, Human / pathology
  • Hepatitis, Viral, Human / surgery*
  • Humans
  • Liver Transplantation*
  • Recurrence

Substances

  • Antiviral Agents