John Libbey Eurotext

Hépato-Gastro & Oncologie Digestive

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Treatment of HCV with Direct Acting Antivirals (DAAs) in patients before and after liver transplantation Volume 23, supplement 1, Février 2016

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Authors
CHU Saint-Éloi, service d’hépato-gastroentérologie et transplantation hépatique, 80, rue Augustin Fliche, 34295 Montpellier cedex 5, France
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HCV recurrence after liver transplantation is a major problem with consequences on graft and patient survival. The treatment of HCV infection before transplantation eliminates post-transplant viral recurrence. Previously, the treatment of hepatitis C was interferon-based which should not be used in case of decompensated cirrhosis. After liver transplantation, the risks were rejection, infection, with a poor tolerance and low virological response. The combination of sofosbuvir with an NS5A inhibitor now enables a virological response in 90% of cases in patients with compensated cirrhosis. In severe cirrhosis, the recovery of the liver function remains uncertain with a possible risk of decompensation. After liver transplantation, direct acting antivirals have shown excellent results, similar to those in non-transplanted patients. Preemptive treatment must be considered after liver transplantation, since graft reinfection is ineluctable.