Editorial
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Pharmacol Ther. Nov 6, 2015; 6(4): 105-110
Published online Nov 6, 2015. doi: 10.4292/wjgpt.v6.i4.105
Pharmaceutical management of hepatitis B and C in liver and kidney transplant recipients
Chrysoula Pipili, Evangelos Cholongitas
Chrysoula Pipili, Division of Nephrology, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, Scotland, United Kingdom
Evangelos Cholongitas, 4th Department of Internal Medicine, Medical School of Aristotle University, Hippokration General Hospital of Thessaloniki, 54642 Thessaloniki, Greece
Author contributions: Authors contributed equally in writing and editing of the article.
Conflict-of-interest statement: There are no conflicts of interest.
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: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Evangelos Cholongitas, Assistant Professor of Internal Medicine, 4th Department of Internal Medicine, Medical School of Aristotle University, Hippokration General Hospital of Thessaloniki, 49, Konstantinopoleos Street, 54642 Thessaloniki, Greece. cholongitas@yahoo.gr
Telephone: +30-69-36378903 Fax: +30-23-10992940
Received: May 16, 2015
Peer-review started: May 18, 2015
First decision: June 24, 2015
Revised: July 5, 2015
Accepted: July 29, 2015
Article in press: August 3, 2015
Published online: November 6, 2015
Processing time: 180 Days and 2.9 Hours
Abstract

The combination of hepatitis B immune globulin with entecavir or tenofovir (at least for a certain period of time) seems to be the most reasonable prophylaxis against recurrent hepatitis B after liver transplantation. Entecavir represents an attractive option for treatment of naïve kidney transplant recipients, because of its high efficacy and the low rates of resistance. However antiviral treatment should be individualized in the view of kidney function and the previous resistance. To date, new captivating therapeutic strategies could make interferon-free regimens viable for treatment of hepatitis C virus positive liver transplant recipients. The recent combinations of sofosbuvir with simeprevir or daclatasvir or ledipasvir plus/minus ribavirin have boosted the on treatment and sustained virological response to rates approaching 100% within liver transplant recipients with recurrent chronic hepatitis C (CHC). Preliminary data showed that the second generation direct oral antivirals could result to high treatment rates of recurrent CHC in kidney transplant recipients as well. Ongoing studies will clarify the optimal treatment of recurrent CHC in kidney transplant recipients.

Keywords: Viral hepatitis; Hepatitis C recurrence; Hepatitis B; Hepatitis C; Liver transplantation; Kidney transplantation hepatitis B recurrence

Core tip: Emphasis should be placed in the appropriate nucleo(s)tide analog selection for prevention of recurrent hepatitis B virus post liver and kidney transplantation; Second generation direct acting oral antivirals have demonstrated sustained virological response rates approaching 100%, minimal side effects and drug interactions on liver transplant recipients with chronic hepatitis C virus (HCV); Preliminary data showed outstanding response of kidney transplant recipients with chronic HCV to direct acting oral antivirals.