Evidence of Spontaneous Post-transplant HCV Eradication in Two Failed DAA Treatments Awaiting Liver Transplantation

Excerpt

Recurrence of HCV infection (rHCV) in patients with detectable HCV-RNA at the time of liver transplantation (LT) is almost universal and is associated with a rapidly progressing course, leading to chronic hepatitis and cirrhosis [1]. Transplant recipients with high levels of HCV-RNA prior to LT are more likely to experience fibrosis progression and poor outcome [1]. It is therefore essential to consider early antiviral therapy in the transplant setting, since achievement of sustained virological response (SVR) improves clinical outcomes and survival rates in LT recipients [2]. The recent introduction of direct-acting antivirals (DAAs) has revolutionized the management of HCV therapy [3]. The use of new DAAs has resulted in high SVR rates, with short treatment courses and excellent safety profiles. Yet, the optimal timing of antiviral therapy in the liver transplant setting is still under discussion. …