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Timing of Hepatitis C Virus Treatment in Liver Transplant Candidates in the Era of Direct-acting Antiviral Agents

Journal of Clinical and Translational Hepatology 2017年第4期5卷 363-367页

作者： George Cholankeril Mairin Joseph-Talreja Brandon J.Perumpail Andy Liu Eric R.Yoo Aijaz Ahmed aparna goel Division of Gastroenterology and Hepatology Stanford University School of MedicineStanfordCAUSA Department of Medicine Drexel University College of MedicinePhiladelphiaPAUSA Department of Medicine California Pacific Medical CenterSan FranciscoCAUSA Department of Medicine Santa Clara Valley Medical CenterSan JoseCAUSA

Chronic hepatitis C virus(HCV)infection remains the leading indication for liver transplantation(LT)in the United *** most patients with chronic HCV infection remain asymptomatic,up to one-third develop progressive liver disease resulting in *** is often the only curative treatment once significant hepatic decompensation ***,antiviral therapy for HCV infection has advanced markedly in the past 5 years with the discovery and approval of direct-acting antiviral *** new regimens are well tolerated,of short duration and highly effective,unlike the traditional treatment with pegylated-interferon and *** achieving sustained virological response becomes increasingly attainable for a majority of HCV-infected patients,concerns have been raised regarding the optimal timing of treatment for HCV infection in the setting of end-stage liver disease and during the peri-transplant *** one hand,HCV treatment may improve hepatic function and negate the need for LT in some,which is crucial given the scarcity of donor organs and mortality on the waiting list in certain *** the other hand,HCV treatment may result in lowering the priority for LT without improving quality of life,thereby delaying potentially curative LT *** review evaluates the evidence supporting the use of direct-acting antiviral agents in the period before and following LT.

关键词： Hepatitis C virus Direct-acting antiviral therapy Liver transplantation

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