https://aasldpubs.onlinelibrary.wiley.com/doi/pdf/10.1002/hep.20704

AASLD practice guidelines: Evaluation of the patient for liver transplantation

The treatment of hepatitis C has dramatically improved over the past decade. Unlike any other chronic viral infection, a significant proportion of patients with chronic hepatitis C can be cured. However, the current standard therapy—pegylated interferon alpha and ribavirin—has its limitations. Limited efficacy in patients with hepatitis C virus (HCV) genotype 1 and the side effect profile will necessitate the development of new therapeutic approaches. This review describes the efficacy and optimisation of the current standard therapy of hepatitis C and its problems in special patient populations. New treatment directions beyond interferon alpha based therapies are on the horizon.

Early identification of patients with acute HCV infection is important for their optimal management. The rate of chronic evolution is 50–90%, and the natural course of chronic hepatitis C can be associated with severe complications. Patients with chronic hepatitis C have the potential risk of developing liver cirrhosis and hepatocellular carcinoma.1 The social burden of HCV infection is high, including for health care workers. Extrahepatic manifestations of HCV are often troublesome and may not be reversible with viral eradication.2 These are good reasons for the design of a prophylactic vaccine but as this has yet to be accomplished, early treatment of acute HCV infection with interferon alpha (IFN) is the only option to prevent chronicity.

Immediate treatment of patients with symptomatic acute hepatitis C with recombinant IFN or pegylated IFN (PEG-IFN) monotherapy for 24 weeks can prevent the development of chronic hepatitis C in approximately 90% of cases.3–5 Combination with ribavirin is not necessary.6 However, symptomatic patients also have a good chance to clear HCV spontaneously.7,8 This usually occurs in the first 12 weeks after the onset of symptoms. A wait and see strategy (that is, treatment of only those patients who remain HCV-RNA …

/pdf/treating-viral-hepatitis-c-efficacy-side-effects-and-d1lczqz62m.pdf

Treating viral hepatitis C: efficacy, side effects, and complications

On the basis of phylogenetic analysis of nucleotide sequences, multiple genotypes and subtypes of hepatitis C virus (HCV) have been identified. Characterization of these genetic groups is likely to facilitate and contribute to the development of an effective vaccine against infection with HCV. Differences among HCV genotypes in geographic distributions have provided investigators with an epidemiologic marker that can be used to trace the source of HCV infection in a given population. HCV genotype 1 may represent a more aggressive strain and one that is less likely to respond to interferon treatment than HCV genotype 2 or 3. However, these observations require confirmation before HCV genotyping can be used in clinical settings.

https://cmr.asm.org/content/cmr/13/2/223.full.pdf

Clinical Significance of Hepatitis C Virus Genotypes

https://aasldpubs.onlinelibrary.wiley.com/doi/epdf/10.1002/hep.510280333

Predictors of patient and graft survival following liver transplantation for hepatitis C

https://aasldpubs.onlinelibrary.wiley.com/doi/pdf/10.1053/jlts.2002.31748

A pilot study of the tolerability and efficacy of antiviral therapy in hepatitis C virus-infected patients awaiting liver transplantation.

Long-term outcome of hepatitis C virus infection after liver transplantation

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Long-term outcome of hepatitis C virus infection after liver transplantation

Long-term outcome of hepatitis C virus infection after liver transplantation