Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Jan 8, 2016; 8(1): 69-73
Published online Jan 8, 2016. doi: 10.4254/wjh.v8.i1.69
Treatment strategies for chronic hepatitis C prior to and following liver transplantation
Ryan B Perumpail, Thomas A Hahambis, Avin Aggarwal, Zobair M Younossi, Aijaz Ahmed
Ryan B Perumpail, Avin Aggarwal, Aijaz Ahmed, Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Palo Alto, CA 94304, United States
Thomas A Hahambis, Gilead Sciences, Foster City, CA 94404, United States
Zobair M Younossi, Center for Liver Diseases, Department of Medicine, Inova Fairfax Hospital, Falls Church, VA 22042, United States
Zobair M Younossi, Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA 22042, United States
Author contributions: Perumpail RB prepared first and final draft, revised the final draft based on feedback from other authors; Hahambis TA prepared first and final draft with the first author; Aggarwal A, Younossi ZM and Ahmed A reviewed and revised each segment of the document and checked references for completeness.
Conflict-of-interest statement: Ryan B Perumpail and Avin Aggarwal have no conflict of interest; Thomas A Hahambis is Gilead Employee: Senior Medical Scientist, Hepatitis; Zobair M Younossi is Advisory Board and/or Consultant to Gilead, Abbvie, BMS, GSK, and Intercept; Aijaz Ahmed is Advisory Board: Gilead. Research Funding: Gilead.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Ryan B Perumpail, MD, Division of Gastroenterology and Hepatology, Stanford University School of Medicine, 750 Welch Road, Suite 210, Palo Alto, CA 94304, United States.
Telephone: +1-650-4986091 Fax: +1-650-4985692
Received: August 20, 2015
Peer-review started: August 22, 2015
First decision: October 30, 2015
Revised: October 30, 2015
Accepted: December 17, 2015
Article in press: December 18, 2015
Published online: January 8, 2016
Core Tip

Core tip: The historic standard of care during the interferon era of hepatitis C virus (HCV) therapy was expectant management-initiation of antiviral therapy in the setting of documented disease progression following liver transplantation. With the advent of new direct acting antiviral (DAA) therapies for HCV, the paradigm of expectant treatment for recurrent HCV infection post-liver transplantation (LT) is shifting. The safety, tolerability, and efficacy of DAAs, even among the sickest patients with advanced liver disease, enables treatment of HCV in the pre-transplant setting among LT waitlist registrants. Emerging data support preemptive therapy with DAAs in liver transplant recipients as the preferred approach.