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Presenter: Marina, Berenguer, , Spain
Authors: Marina Berenguer
Overview
In the past few years, the landscape of antiviral therapy has evolved in an amazing way from pegylated interferon (PEG-IFN) plus Ribavirin (RBV) to IFN-based strategies that combine direct acting antivirals (DDAs) with PEG-IFN to, finally, IFN-free combination of DAAs. With the advent of these new oral antivirals, treatment of classically considered difficult to treat patients, such as liver transplant candidates and recipients, can now be achieved with easy and short regimens which are very well tolerated and result in the cure of the infection in almost 95% of patients, particularly when treatment is started at early stages of fibrosis. Eradication of Hepatitis C virus is associated with regression or “freezing” of cirhosis even if it is still unknown the point of no return where this has no benefit for the patient. Whether this will translate into a reduction in the need for transplantation remains to be proven but is highly possible.
In turn, oral antivirals against HBV have already shown to reduce the need for liver transplantation and effectively prevent viral recurrence. Hepatitis B immune globulins are still needed in some instances, particularly in patients at high risk of recurrence.
Objectives
1- To understand the significant revolution in the landscape of antiviral therapy against HCV.
2- To determine the best strategies to prevent HBV and HCV recurrence following liver transplantation
3- To acknowledge current limitations with oral antivirals both before and after liver transplantation.
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