Clin Mol Hepatol.  2014 Dec;20(4):338-344. 10.3350/cmh.2014.20.4.338.

Management of viral hepatitis in liver transplant recipients

Affiliations
  • 1Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea.
  • 2Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.
  • 3Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. kimjw@snubh.org

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.

Keyword

Liver transplantation; Viral hepatitis; Recurrence; Management; Antiviral therapy

MeSH Terms

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