New Insights in Recurrent HCV Infection after Liver Transplantation

Hsu, Shih-Hsien; Yeh, Ming-Lun; Wang, Shen-Nien

Recurrence of HCV infection in the liver allograft is universal after LT, and its natural history is variable. It has been estimated that approximately 20% of recipients will progress to graft cirrhosis within 5 years of transplant [7] . Overall, HCV disease is more aggressive in the posttransplant recipients than in patients whose immunity is intact [8] . Accelerated disease progression is multifactorial and probably depends on a number of variables, including host, donor, viral, and external factors. However, the definite interactions between these factors and recurrent HCV infection in the liver allograft still remain controversial and poorly defined. Thus, to identify recipients at risk for rapid HCV recurrence after LT will be helpful especially when considering treatment with the currently available antiviral agents either as prophylaxis or therapy. To date, a number of risk factors have been mentioned regarding this clinical issue.