Recurrent hepatitis C after liver transplantation

Cirrhosis due to hepatitis C is now the commonest indication for liver tran splantation in Western Europe and in the United States. Graft reinfection i s almost universal. The natural history of recurrent hepatitis C ranges fro m minimal damage to cirrhosis in a few months or years. Different virus and host immune factors are involved in the pathogenesis of hepatitis and are determinants of the outcome. The association between immunosuppression and severity of HCV recurrence is conflicting and remains to be evaluated fully . The treatment of recurrent HCV disease with IFN or ribavirin, as monother apy, is ineffective. Preliminary results from combination therapy, however, are encouraging. Currently, a reasonable approach would be to treat patien ts with histological and clinical disease progression. New approaches for t he prophylaxis of recurrent hepatitis C are under evaluation but whether th is treatment will influence the severity of liver disease or the outcome of recurrence is still unknown. J. Med. Virol. 61:443-454, 2000. (C) 2000 Wil ey-Liss, Inc.