transplantologiyaТрансплантологияTransplantologiya. The Russian Journal of Transplantation2074-05062542-0909IPO Association of Transplantologists10.23873/2074-0506-2010-0-2-10-17transplantologiya-277Research ArticleОБЗОРНЫЕ СТАТЬИ И ЛЕКЦИИREVIEW ARTICLES AND LECTURESЛечение возвратной инфекции HCV после трансплантации печени по поводу терминальных стадий хронического гепатита СTreatment for recurrent HCV infection after liver transplantation for final stages of chronic hepatitis ССюткинВ. Е.SyutkinV. E.

Владимир Евгеньевич Сюткин

vsyutkin@rambler.ruАндрейцеваО. И.AndreitsevaO. I.КозловаА. В.KozlovaA. V.НИИ скорой помощи им. Н.В. СклифосовскогоРоссияN.V. Sklifosovsky Research Institute of Emergency CareRussian Federation201017082018021017Copyright © Сюткин В.Е., Андрейцева О.И., Козлова А.В., 20182018Сюткин В.Е., Андрейцева О.И., Козлова А.В.Syutkin V.E., Andreitseva O.I., Kozlova A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.jtransplantologiya.ru/jour/article/view/277

В обзоре обсуждаются возможности проведения противовирусной терапии возвратной инфекции вирусного гепатита С (HCV) после трансплантации печени. Проанализированы концепции упреждающей терапии, начатой в первые недели после трансплантации, а также терапии «по факту» гистологического подтверждения активного гепатита и/или фиброза печени. Рассмотрены возможности и ограничения в использовании пегилированных интерферонов и рибавирина в виде монотерапии или комбинированного лечения. Особое внимание уделено роли вирусной кинетики в определении продолжительности предстоящей терапии, в том числе возможности ее продления >12 мес. Представлены аргументы в пользу более благоприятного течения возвратной инфекции HCV у больных, получающих циклоспорин, по сравнению с пациентами, принимающими такролимус.

The review discusses whether antiviral therapy for recurrent hepatitis C virus (HCV) infection may be used following liver transplantation. It analyzes the concepts of pre-emptive therapy initiated within the first weeks after the transplantation, as well as therapy for histologically verified active hepatitis and/or liver fibrosis. Capabilities and limits in the use of pegylated interferons and ribavirin as monotherapy or combination therapy are considered. Particular emphasis is placed on the role of viral kinetics in the determination of the duration of further therapy, including the possibility of its prolongation up to > 12 months. There are arguments in favor of a better course of recurrent HCV infection in patients receiving cyclosporine versus those taking tacrolimus.

хронический гепатит Спегилированный интерферонрибавиринциклоспоринтрансплантация печениchronic hepatitis Cpegylated interferonribavirincyclosporineliver transplantationReferencesTerrault N.A., Berenguer M. Treating hepatitis C infection in liver transplant recipients. Liver Transpl 2006;12:1192–204.Terrault N.A., Berenguer M. Treating hepatitis C infection in liver transplant recipients. Liver Transpl 2006;12:1192–204.Gish R.G., Afdhal N.H., Dieterich D.T., Reddy K.R. Management of hepatitis C virus in special populations: patient and treatment considerations. Clin Gastroenterol Hepatol 2005;3:311–8.Gish R.G., Afdhal N.H., Dieterich D.T., Reddy K.R. Management of hepatitis C virus in special populations: patient and treatment considerations. Clin Gastroenterol Hepatol 2005;3:311–8.Alter H.J., Seeff L.B. Recovery, persistence, and sequelae in hepatitis C virus infection: a perspective on long-term outcome. Semin Liver Dis 2000;20:17–35.Alter H.J., Seeff L.B. Recovery, persistence, and sequelae in hepatitis C virus infection: a perspective on long-term outcome. Semin Liver Dis 2000;20:17–35.Berenguer M., Prieto M., Rayon J.M. et al. Natural history of clinically compensated hepatitis C virus-related graft cirrhosis after liver transplantation. Hepatology 2000;32:852–8.Berenguer M., Prieto M., Rayon J.M. et al. Natural history of clinically compensated hepatitis C virus-related graft cirrhosis after liver transplantation. Hepatology 2000;32:852–8.Berenguer M., Palau A., Fernandez A. et al. Efficacy, predictors of response, and potential risks associated with antiviral therapy in liver transplant recipients with recurrent hepatitis C. Liver Transpl 2006;12:1067–76.Berenguer M., Palau A., Fernandez A. et al. Efficacy, predictors of response, and potential risks associated with antiviral therapy in liver transplant recipients with recurrent hepatitis C. Liver Transpl 2006;12:1067–76.Berenguer M. Natural history of recurrent hepatitis C. Liver Transpl 2002;8 (suppl 1):14–8.Berenguer M. Natural history of recurrent hepatitis C. Liver Transpl 2002;8 (suppl 1):14–8.Thuluvath P.J., Krok K.L., Segev D.L. et al. Trends in post-liver transplant survival in patients with hepatitis C between 1991 and 2001 in the United States. Liver Transpl 2007;13:719–24.Thuluvath P.J., Krok K.L., Segev D.L. et al. Trends in post-liver transplant survival in patients with hepatitis C between 1991 and 2001 in the United States. Liver Transpl 2007;13:719–24.Saab S., Niho H., Comulada S. et al. Mortality predictors in liver transplant recipients with recurrent hepatitis C cirrhosis. Liver Int 2005;25:940–5.Saab S., Niho H., Comulada S. et al. Mortality predictors in liver transplant recipients with recurrent hepatitis C cirrhosis. Liver Int 2005;25:940–5.Sheiner P.A., Boros P., Klion F.M. et al. The efficacy of prophylactic interferon alfa-2b in preventing recurrent hepatitis C after liver transplantation. Hepatology 1998;28:831–8.Sheiner P.A., Boros P., Klion F.M. et al. The efficacy of prophylactic interferon alfa-2b in preventing recurrent hepatitis C after liver transplantation. Hepatology 1998;28:831–8.Singh N., Gayowski T., Wannstedt C.F. et al. Interferon-alpha for prophylaxis of recurrent viral hepatitis C in liver transplant recipients. Transplantation 1998;65:82–6.Singh N., Gayowski T., Wannstedt C.F. et al. Interferon-alpha for prophylaxis of recurrent viral hepatitis C in liver transplant recipients. Transplantation 1998;65:82–6.Belli L.S., Alberti A.B., Rondinara G.F. et al. Early ribavirin treatment and avoidance of corticosteroids in hepatitis C virus positive liver transplant recipients: interim report of a prospective randomized trial. Transplant Proc 2001;33:1353–4.Belli L.S., Alberti A.B., Rondinara G.F. et al. Early ribavirin treatment and avoidance of corticosteroids in hepatitis C virus positive liver transplant recipients: interim report of a prospective randomized trial. Transplant Proc 2001;33:1353–4.Mazzaferro V., Tagger A., Schiavo M. et al. Prevention of recurrent hepatitis C after liver transplantation with early interferon and ribavirin treatment. Transplant Proc 2001;33:1355–7.Mazzaferro V., Tagger A., Schiavo M. et al. Prevention of recurrent hepatitis C after liver transplantation with early interferon and ribavirin treatment. Transplant Proc 2001;33:1355–7.Sugawara Y., Makuuchi M., Matsui Y. et al. Preemptive therapy for hepatitis C virus after living-donor liver transplantation. Transplantation 2004; 78:1308–11.Sugawara Y., Makuuchi M., Matsui Y. et al. Preemptive therapy for hepatitis C virus after living-donor liver transplantation. Transplantation 2004; 78:1308–11.Shergill A.K., Khalili M., Straley S. et al. Applicability, tolerability and efficacy of preemptive antiviral therapy in hepatitis C-infected patients undergoing liver transplantation. Am J Transplant 2005;5:118–24.Shergill A.K., Khalili M., Straley S. et al. Applicability, tolerability and efficacy of preemptive antiviral therapy in hepatitis C-infected patients undergoing liver transplantation. Am J Transplant 2005;5:118–24.Chalasani N., Manzarbeitia C., Ferenci P. et al. Peginterferon alfa-2a for hepatitis C after liver transplantation: two randomized, controlled trial (published erratum appears in Hepatology 2005;42:506). Hepatology 2005; 41:289–98.Chalasani N., Manzarbeitia C., Ferenci P. et al. Peginterferon alfa-2a for hepatitis C after liver transplantation: two randomized, controlled trial (published erratum appears in Hepatology 2005;42:506). Hepatology 2005; 41:289–98.Castells L., Vargas V., Allende H. et al. Combined treatment with pegylated interferon (alpha-2b) and ribavirin in the acute phase of hepatitis C virus recurrence after liver transplantation. J Hepatol 2005;43:53–9.Castells L., Vargas V., Allende H. et al. Combined treatment with pegylated interferon (alpha-2b) and ribavirin in the acute phase of hepatitis C virus recurrence after liver transplantation. J Hepatol 2005;43:53–9.Zimmermann T., Bocher W.O., Biesterfeld S. et al. Efficacy of an escalating dose regimen of pegylated interferon alpha2a plus ribavirin in the early phase of HCV reinfection after liver transplantation. Transpl Int 2007; 20:583–90.Zimmermann T., Bocher W.O., Biesterfeld S. et al. Efficacy of an escalating dose regimen of pegylated interferon alpha2a plus ribavirin in the early phase of HCV reinfection after liver transplantation. Transpl Int 2007; 20:583–90.Kuo A., Tan V., Lan B. et al. Long-term histological effects of preemptive antiviral therapy in liver transplant recipients with hepatitis C virus infection. Liver Transpl 2008;14:1491–7.Kuo A., Tan V., Lan B. et al. Long-term histological effects of preemptive antiviral therapy in liver transplant recipients with hepatitis C virus infection. Liver Transpl 2008;14:1491–7.Wang C.S., Ko H.H., Yoshida E.M. et al. Interferon-based combination antiviral therapy for hepatitis C virus after liver transplantation: a review and quantitative analysis. Am J Transplant 2006;6:1586–99.Wang C.S., Ko H.H., Yoshida E.M. et al. Interferon-based combination antiviral therapy for hepatitis C virus after liver transplantation: a review and quantitative analysis. Am J Transplant 2006;6:1586–99.Berenguer M. Systematic review of the treatment of established recurrent hepatitis C with pegylated interferon in combination with ribavirin. J Hepatol 2008;49:274–87.Berenguer M. Systematic review of the treatment of established recurrent hepatitis C with pegylated interferon in combination with ribavirin. J Hepatol 2008;49:274–87.Bizollon T., Pradat P., Mabrut J.Y. et al. Histological benefit of retreatment by pegylated interferon alfa-2b and ribavirin in patients with recurrent hepatitis C virus infection posttransplantation. Am J Transplant 2007;7:448–53.Bizollon T., Pradat P., Mabrut J.Y. et al. Histological benefit of retreatment by pegylated interferon alfa-2b and ribavirin in patients with recurrent hepatitis C virus infection posttransplantation. Am J Transplant 2007;7:448–53.Nair S., Lipscomb J., Eason J. Efficacy of interferon based antiviral therapy for recurrent hepatitis C in patients who received steroid free immunosuppression for liver transplantation. Transplantation 2008;86:418–22.Nair S., Lipscomb J., Eason J. Efficacy of interferon based antiviral therapy for recurrent hepatitis C in patients who received steroid free immunosuppression for liver transplantation. Transplantation 2008;86:418–22.Ueda Y., Takada Y., Haga H. et al. Limited benefit of biochemical response to combination therapy for patients with recurrent hepatitis C after living-donor liver transplantation. Transplantation 2009;85:855–62.Ueda Y., Takada Y., Haga H. et al. Limited benefit of biochemical response to combination therapy for patients with recurrent hepatitis C after living-donor liver transplantation. Transplantation 2009;85:855–62.Raziorrouh B., Jung M.C., Schirren C.A. et al. Antiviral therapy for recurrent hepatitis C after liver transplantation: sustained virologic response is related to genotype 2/3 and response at week 12. Eur J Gastroenterol Hepatol 2008;20:778–83.Raziorrouh B., Jung M.C., Schirren C.A. et al. Antiviral therapy for recurrent hepatitis C after liver transplantation: sustained virologic response is related to genotype 2/3 and response at week 12. Eur J Gastroenterol Hepatol 2008;20:778–83.Dinges S., Morard I., Heim M. et al. Pegylated interferon alpha 2a/ribavirin treatment of recurrent hepatitis C after liver transplantation. Transpl Infect Dis 2009;11:33–9.Dinges S., Morard I., Heim M. et al. Pegylated interferon alpha 2a/ribavirin treatment of recurrent hepatitis C after liver transplantation. Transpl Infect Dis 2009;11:33–9.Walter T., Scoazec J.Y., Guillaud O. et al. Long-term antiviral therapy for recurrent hepatitis C after liver transplantation in nonresponders: biochemical, virological, and histological impact. Liver Transpl 2009; 15:54–63.Walter T., Scoazec J.Y., Guillaud O. et al. Long-term antiviral therapy for recurrent hepatitis C after liver transplantation in nonresponders: biochemical, virological, and histological impact. Liver Transpl 2009; 15:54–63.Cescon M., Grazi G.L., Cucchetti A. et al. Predictors of sustained virological response after antiviral treatment for hepatitis C recurrence following liver transplantation. Liver Transpl 2009;15:782–9.Cescon M., Grazi G.L., Cucchetti A. et al. Predictors of sustained virological response after antiviral treatment for hepatitis C recurrence following liver transplantation. Liver Transpl 2009;15:782–9.Berenguer M., Aguilera V., Prieto M. et al. Worse recent efficacy of antiviral therapy in liver transplant recipients with recurrent hepatitis C: impact of donor age and baseline cirrhosis. Liver Transpl 2009;15:738–46.Berenguer M., Aguilera V., Prieto M. et al. Worse recent efficacy of antiviral therapy in liver transplant recipients with recurrent hepatitis C: impact of donor age and baseline cirrhosis. Liver Transpl 2009;15:738–46.Jain A., Sharma R., Ryan C. et al. Response to antiviral therapy in liver transplant recipients with recurrent hepatitis C viral infection: a single center experience. Clin Transplant 2010;24:104–11.Jain A., Sharma R., Ryan C. et al. Response to antiviral therapy in liver transplant recipients with recurrent hepatitis C viral infection: a single center experience. Clin Transplant 2010;24:104–11.Torriani F.J., Ribeiro R.M., Gilbert T.L. et al. Hepatitis C virus (HCV) and human immunodeficiency virus (HIV) dynamics during HCV treatment in HCV/HIV coinfection. J Infect Dis 2003;188:1498–507.Torriani F.J., Ribeiro R.M., Gilbert T.L. et al. Hepatitis C virus (HCV) and human immunodeficiency virus (HIV) dynamics during HCV treatment in HCV/HIV coinfection. J Infect Dis 2003;188:1498–507.Adeyemi O.M. Hepatitis C in HIVpositive patients – treatment and liver disease outcomes. J Clin Gastroenterol 2007;41:75–87.Adeyemi O.M. Hepatitis C in HIVpositive patients – treatment and liver disease outcomes. J Clin Gastroenterol 2007;41:75–87.Oton E., Barcena R., Moreno-Planas J.M. et al. Hepatitis C recurrence after liver transplantation: viral and histologic response to full-dose PEG-interferon and ribavirin. Am J Transplant 2006;6:2348–55.Oton E., Barcena R., Moreno-Planas J.M. et al. Hepatitis C recurrence after liver transplantation: viral and histologic response to full-dose PEG-interferon and ribavirin. Am J Transplant 2006;6:2348–55.Dumortier J., Scoazec J.Y., Chevallier P. Treatment of recurrent hepatitis C after liver transplantation: a pilot study of peginterferon alfa-2b and ribavirin combination. J Hepatol 2004;40:669–74.Dumortier J., Scoazec J.Y., Chevallier P. Treatment of recurrent hepatitis C after liver transplantation: a pilot study of peginterferon alfa-2b and ribavirin combination. J Hepatol 2004;40:669–74.Bahra M., Neumann U.P., Jacob D. et al. Fibrosis progression in hepatitis C positive liver recipients after sustained virologic response to antiviral combination therapy (interferon-ribavirin therapy). Transplantation 2007;83: 351–3.Bahra M., Neumann U.P., Jacob D. et al. Fibrosis progression in hepatitis C positive liver recipients after sustained virologic response to antiviral combination therapy (interferon-ribavirin therapy). Transplantation 2007;83: 351–3.Bizollon T., Pradat P., Mabrut J.Y. et al. Benefit of sustained virological response to combination therapy on graft survival of liver transplanted patients with recurrent chronic hepatitis C. Am J Transplant 2005;5:1909–13.Bizollon T., Pradat P., Mabrut J.Y. et al. Benefit of sustained virological response to combination therapy on graft survival of liver transplanted patients with recurrent chronic hepatitis C. Am J Transplant 2005;5:1909–13.Picciotto F.P., Tritto G., Lanza A.G. et al. Sustained virological response to antiviral therapy reduces mortality in HCV reinfection after liver transplantation. J Hepatol 2007;46:459–65.Picciotto F.P., Tritto G., Lanza A.G. et al. Sustained virological response to antiviral therapy reduces mortality in HCV reinfection after liver transplantation. J Hepatol 2007;46:459–65.Lilly L., Selzner N., Therapondos G. et al. Improved survival in liver transplant recipients (LT) treated for recurrent hepatitis C (HCV) is seen in both relapsers and in sustained responders. Paper presented at: 2008 American Transplant Congress; May 31–June 4, 2008. Toronto, Canada.Lilly L., Selzner N., Therapondos G. et al. Improved survival in liver transplant recipients (LT) treated for recurrent hepatitis C (HCV) is seen in both relapsers and in sustained responders. Paper presented at: 2008 American Transplant Congress; May 31–June 4, 2008. Toronto, Canada.Ikegami T., Taketomi A., Soejima Y. et al. The benefits of interferon treatment in patients without sustained viral response after living donor liver transplantation for hepatitis C. Transplant Proc 2009;41(10):4246–52.Ikegami T., Taketomi A., Soejima Y. et al. The benefits of interferon treatment in patients without sustained viral response after living donor liver transplantation for hepatitis C. Transplant Proc 2009;41(10):4246–52.Veldt B.J., Poterucha J.J., Watt K.D.S. et al. Impact of pegylated interferon and ribavirin treatment on graft survival in liver transplant patients with recurrent hepatitis C infection. Am J Transpl 2008;8:2426–33.Veldt B.J., Poterucha J.J., Watt K.D.S. et al. Impact of pegylated interferon and ribavirin treatment on graft survival in liver transplant patients with recurrent hepatitis C infection. Am J Transpl 2008;8:2426–33.Fernandez I., Meneu J.C., Colina F. et al. Clinical and histological efficacy of pegylated interferon and ribavirin therapy of recurrent hepatitis C after liver transplantation. Liver Transpl 2006;12:1805–12.Fernandez I., Meneu J.C., Colina F. et al. Clinical and histological efficacy of pegylated interferon and ribavirin therapy of recurrent hepatitis C after liver transplantation. Liver Transpl 2006;12:1805–12.Sharma P., Marrero J.A., Fontana R.J. et al. Sustained virologic response to therapy of recurrent hepatitis C after liver transplantation is related to early virologic response and dose adherence. Liver Transpl 2007;13:1100–8.Sharma P., Marrero J.A., Fontana R.J. et al. Sustained virologic response to therapy of recurrent hepatitis C after liver transplantation is related to early virologic response and dose adherence. Liver Transpl 2007;13:1100–8.Carrion J.A., Navasa M., GarcıґaRetortillo M. et al. Efficacy of antiviral therapy on hepatitis C recurrence after liver transplantation: a randomized controlled study. Gastroenterology 2007;132:1746–56.Carrion J.A., Navasa M., GarcıґaRetortillo M. et al. Efficacy of antiviral therapy on hepatitis C recurrence after liver transplantation: a randomized controlled study. Gastroenterology 2007;132:1746–56.Hanouneh I.A., Miller C., Aucejo F. et al. Recurrent hepatitis C after liver transplantation: on treatment prediction of response to peginterferon/ribavirin therapy. Liver Transpl 2008;14:53–8.Hanouneh I.A., Miller C., Aucejo F. et al. Recurrent hepatitis C after liver transplantation: on treatment prediction of response to peginterferon/ribavirin therapy. Liver Transpl 2008;14:53–8.Donato M., Agnelli F., Rigamonti C. et al. Might rapid virological response be used as a stopping rule in liver transplant recipients treated with pegylated interferon plus ribavirin? Liver Transpl 2008;14:1383–4.Donato M., Agnelli F., Rigamonti C. et al. Might rapid virological response be used as a stopping rule in liver transplant recipients treated with pegylated interferon plus ribavirin? Liver Transpl 2008;14:1383–4.Samuel D., Bizollon T., Feray C. et al. Interferon-α2b plus ribavirin in patients with chronic hepatitis C after liver transplantation: a randomized study. Gastroenterology 2003;124:642–50.Samuel D., Bizollon T., Feray C. et al. Interferon-α2b plus ribavirin in patients with chronic hepatitis C after liver transplantation: a randomized study. Gastroenterology 2003;124:642–50.Сюткин В.Е. Новые возможности повышения эффективности противовирусной терапии больных хроническим гепатитом С. Инфекц бол 2009;7(2):55–9.Сюткин В.Е. Новые возможности повышения эффективности противовирусной терапии больных хроническим гепатитом С. Инфекц бол 2009;7(2):55–9.Schmidt S.C., Bahra M., Bayraktar S. et al. Antiviral treatment of patients with recurrent hepatitis C after liver transplantation with pegylated interferon. Dig Dis Sci. 2009 Oct 2. [Epub ahead of print].Schmidt S.C., Bahra M., Bayraktar S. et al. Antiviral treatment of patients with recurrent hepatitis C after liver transplantation with pegylated interferon. Dig Dis Sci. 2009 Oct 2. [Epub ahead of print].Moeller M., Divine G., Brown K.A. Impact of length of therapy and predictive value models on SVR in HCV patients post OLT. Hepatology 2009;50:391.Moeller M., Divine G., Brown K.A. Impact of length of therapy and predictive value models on SVR in HCV patients post OLT. Hepatology 2009;50:391.Angelico M., Petrolati A., Lionetti R. et al. A randomized study on Peginterferon alfa-2a with or without ribavirin in liver transplant recipients with recurrent hepatitis C. J Hepatol 2007;46:1009–17.Angelico M., Petrolati A., Lionetti R. et al. A randomized study on Peginterferon alfa-2a with or without ribavirin in liver transplant recipients with recurrent hepatitis C. J Hepatol 2007;46:1009–17.Vollmer J., Rankin R., Hartmann H. et al. Immunopharmacology of CpG oligodeoxynucleotides and ribavirin. Antimicrob Agents Chemother 2004; 48:2314–17.Vollmer J., Rankin R., Hartmann H. et al. Immunopharmacology of CpG oligodeoxynucleotides and ribavirin. Antimicrob Agents Chemother 2004; 48:2314–17.Zhang Y., Jamaluddin M., Wang S. et al. Ribavirin treatment up-regulates antiviral gene expression via the interferon-stimulated response element in respiratory syncytial virus-infected epithelial cells. J Virol 2003;77:5933–47.Zhang Y., Jamaluddin M., Wang S. et al. Ribavirin treatment up-regulates antiviral gene expression via the interferon-stimulated response element in respiratory syncytial virus-infected epithelial cells. J Virol 2003;77:5933–47.Dixit N.M., Layden J., Layden T. et al. Modelling how ribavirin improves interferon response rates in hepatitis C virus infection. Nature 2004;432:922–4.Dixit N.M., Layden J., Layden T. et al. Modelling how ribavirin improves interferon response rates in hepatitis C virus infection. Nature 2004;432:922–4.Calmus Y., Duvoux C., Pageaux G.P. et al. Multicenter randomized trial in HCV infected patients treated with peginterferon alfa-2a and ribavirin followed by ribavirin alone after liver transplantation: final report. Paper presented at: 2008 American Transplant Congress; May 31–June 4, 2008. Toronto, Canada.Calmus Y., Duvoux C., Pageaux G.P. et al. Multicenter randomized trial in HCV infected patients treated with peginterferon alfa-2a and ribavirin followed by ribavirin alone after liver transplantation: final report. Paper presented at: 2008 American Transplant Congress; May 31–June 4, 2008. Toronto, Canada.Lionetti R., Tisone G., Palmieri G. et al. Maintenance ribavirin monotherapy delays fibrosis progression in liver transplant recipients with recurrent hepatitis C at high risk of progression. Dig Liver Dis 2010;42(4):297–303.Lionetti R., Tisone G., Palmieri G. et al. Maintenance ribavirin monotherapy delays fibrosis progression in liver transplant recipients with recurrent hepatitis C at high risk of progression. Dig Liver Dis 2010;42(4):297–303.Brok J., Gluud L.L., Gluud C. Ribavirin monotherapy for chronic hepatitis C infection: a Cochrane hepato-biliary group systematic review and meta-analysis of randomized trial. Am J Gastroenterol 2006;101(4):842–7.Brok J., Gluud L.L., Gluud C. Ribavirin monotherapy for chronic hepatitis C infection: a Cochrane hepato-biliary group systematic review and meta-analysis of randomized trial. Am J Gastroenterol 2006;101(4):842–7.Stravitz R.T., Shiffman M.L., Sanyal A.J. et al. Effects of interferon treatment on liver histology and allograft rejection in patients with recurrent hepatitis C following liver transplantation. LiverTranspl 2004;10:850–8.Stravitz R.T., Shiffman M.L., Sanyal A.J. et al. Effects of interferon treatment on liver histology and allograft rejection in patients with recurrent hepatitis C following liver transplantation. LiverTranspl 2004;10:850–8.Giostra E., Kullak-Ublick G.A., Keller W. et al. Ribavirin/interferon alpha sequential treatment of recurrent hepatitis C after liver transplantation.Transpl Int 2004;17:169–76.Giostra E., Kullak-Ublick G.A., Keller W. et al. Ribavirin/interferon alpha sequential treatment of recurrent hepatitis C after liver transplantation.Transpl Int 2004;17:169–76.Jolley W.B., Call T.W., Alvord L.S., Hinshaw D.B. Immunosuppressive activity of ribavirin using the rabbit skin allograft model. Ann NY Acad Sci 1977;284:230–2.Jolley W.B., Call T.W., Alvord L.S., Hinshaw D.B. Immunosuppressive activity of ribavirin using the rabbit skin allograft model. Ann NY Acad Sci 1977;284:230–2.Kontorinis N., Agarwal K., Elhajj N. et al. Pegylated interferon induced immunemediated hepatitis post-liver transplantation. LiverTranspl 2006; 12:827–30.Kontorinis N., Agarwal K., Elhajj N. et al. Pegylated interferon induced immunemediated hepatitis post-liver transplantation. LiverTranspl 2006; 12:827–30.Watashi K., Hijakata M., Hosaka M. et al. Cyclosporin A suppresses replication of hepatitis C virus genome in cultured hepatocytes. Hepatology 2003;38:1282–8.Watashi K., Hijakata M., Hosaka M. et al. Cyclosporin A suppresses replication of hepatitis C virus genome in cultured hepatocytes. Hepatology 2003;38:1282–8.Nakagawa M., Sakamoto N., Enomoto N. et al. Specific inhibition of hepatitis C virus replication by cyclosporin A. Biochem Biophys Res Commun 2004;313:42–7.Nakagawa M., Sakamoto N., Enomoto N. et al. Specific inhibition of hepatitis C virus replication by cyclosporin A. Biochem Biophys Res Commun 2004;313:42–7.Manire T., Ethier C., Raymond V.A. et al. Evaluation of the effect of immunosuppressive agents on hepatitis C: cyclosporine reduces viral replication in the replicon model [abstract]. Transplantation 2004;78 (suppl 1):13–4.Manire T., Ethier C., Raymond V.A. et al. Evaluation of the effect of immunosuppressive agents on hepatitis C: cyclosporine reduces viral replication in the replicon model [abstract]. Transplantation 2004;78 (suppl 1):13–4.Sheiner P.A., Schwartz M.E., Mor E. et al. Severe or multiple rejection episodes are associated with early recurrence of hepatitis C after orthotopic liver transplantation. Hepatology 1995;21:30–4.Sheiner P.A., Schwartz M.E., Mor E. et al. Severe or multiple rejection episodes are associated with early recurrence of hepatitis C after orthotopic liver transplantation. Hepatology 1995;21:30–4.Johnson M.W., Washburn W.K., Freeman R.B. et al. Hepatitis C viral infection in liver transplantation. Arch Surg 1996;131:284–91.Johnson M.W., Washburn W.K., Freeman R.B. et al. Hepatitis C viral infection in liver transplantation. Arch Surg 1996;131:284–91.Paik S.W., Tan H.P., Klein A.S. et al. Outcome of orthotopic liver transplantation in patients with hepatitis C. Dig Dis Sci 2002;47:450–5.Paik S.W., Tan H.P., Klein A.S. et al. Outcome of orthotopic liver transplantation in patients with hepatitis C. Dig Dis Sci 2002;47:450–5.Duvoux C., Mennecier D., Pageaux G. et al. Immunosuppression with tacrolimus an absence of antihypertensive therapy are associated with fibrosis progression after hepatitis C virus (HCV) graft reinfection. International Society of Transplantation Congress 2002 [abstract 2652]. Transplantation 2002;74(Suppl).Duvoux C., Mennecier D., Pageaux G. et al. Immunosuppression with tacrolimus an absence of antihypertensive therapy are associated with fibrosis progression after hepatitis C virus (HCV) graft reinfection. International Society of Transplantation Congress 2002 [abstract 2652]. Transplantation 2002;74(Suppl).Hunt J., Gordon F.D., Lewis W.D. et al. Histological recurrence and progression of hepatitis C after orthotopic liver transplantation: influence of immunosuppressive regimens. Liver Transpl 2001;7:1056–63.Hunt J., Gordon F.D., Lewis W.D. et al. Histological recurrence and progression of hepatitis C after orthotopic liver transplantation: influence of immunosuppressive regimens. Liver Transpl 2001;7:1056–63.Berenguer M., Prieto M., San Juan F. et al. Contribution of donor age to the recent decrease in patient survival among HCV-infected liver transplant recipients. Hepatology 2002;36:202–10.Berenguer M., Prieto M., San Juan F. et al. Contribution of donor age to the recent decrease in patient survival among HCV-infected liver transplant recipients. Hepatology 2002;36:202–10.Ghobrial R.M., Farmer D.G., Baquerizo A. et al. Orthotopic liver transplantation for hepatitis C: outcome, effect of immunosuppression, and causes of retransplantation duringan 8-yearsinglecenterexperience. Ann Surg 1999;6:824–33.Ghobrial R.M., Farmer D.G., Baquerizo A. et al. Orthotopic liver transplantation for hepatitis C: outcome, effect of immunosuppression, and causes of retransplantation duringan 8-yearsinglecenterexperience. Ann Surg 1999;6:824–33.Neumann U.P., Berg T., Bahra M. et al. Long-term outcome of liver transplants for chronic hepatitis C: a 10-year follow-up. Transplantation 2004;77:226–31.Neumann U.P., Berg T., Bahra M. et al. Long-term outcome of liver transplants for chronic hepatitis C: a 10-year follow-up. Transplantation 2004;77:226–31.Levy G., Grazi G.L., Sanjuan F. et al. 12-month follow-up analysis of a multicenter, randomized, prospective trial in de novo liver transplant recipients (LIS2T) comparing cyclosporine microemulsion (C2 monitoring) and tacrolimus. Liver Transpl 2006;12:1464–72.Levy G., Grazi G.L., Sanjuan F. et al. 12-month follow-up analysis of a multicenter, randomized, prospective trial in de novo liver transplant recipients (LIS2T) comparing cyclosporine microemulsion (C2 monitoring) and tacrolimus. Liver Transpl 2006;12:1464–72.Firpi R.J., Zhu H., Morelli G. et al. Cyclosporine suppresses hepatitis C virus in vitro and increases the chance of a sustained virological response after liver transplantation. Liver Transpl 2006;12:51–7.Firpi R.J., Zhu H., Morelli G. et al. Cyclosporine suppresses hepatitis C virus in vitro and increases the chance of a sustained virological response after liver transplantation. Liver Transpl 2006;12:51–7.Selzner N., Renner E.L., Selzner M. et al. Antiviral treatment of recurrent hepatitis C after liver transplantation: predictors of response and long-term outcome. Transplantation 2009;88(10):1214–21.Selzner N., Renner E.L., Selzner M. et al. Antiviral treatment of recurrent hepatitis C after liver transplantation: predictors of response and long-term outcome. Transplantation 2009;88(10):1214–21.

The authors declare that there are no conflicts of interest present.