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Semin Liver Dis 2006; 26(3): 285-297
DOI: 10.1055/s-2006-947298
DOI: 10.1055/s-2006-947298
Viral Hepatitis and Liver Transplantation
Further Information
Publication History
Publication Date:
19 July 2006 (online)
ABSTRACT
Hepatitis C is the one of the most common indications for liver transplantation. Infection of the allograft after transplantation is universal, and recurrent hepatitis C progresses at an accelerated rate. Antiviral therapy in selected patients on the transplant waiting list may reduce the rate of hepatitis C virus reinfection. Preemptive antiviral therapy after transplantation has been disappointing. However, treatment of established histological disease with a combination of pegylated interferon and ribavirin is associated with sustained virologic response rates of 25 to 40%. Significant advances have been made in the prevention of hepatitis B reinfection after transplantation. Results are now excellent, with graft infection rates less than 10%. The challenges for the future include designing strategies to optimize the use of antiviral agents to prevent the need for transplantation and to avoid antiviral resistance and to determine the dose and duration of hepatitis B immunoglobulin needed in the era of multiple nucleoside analogs.
KEYWORDS
Hepatitis C - hepatitis B - interferon - hepatitis B immunoglobulin - antiviral therapy
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Anna LokM.D.
Professor of Medicine, Division of Gastroenterology, University of Michigan Health
System, 1500 East Medical Center Drive
3912 Taubman Center, Ann Arbor, MI 48109-0362