Skip to main content
Log in

Hepatitis C Virus Treatment in Non-Liver Organ Transplantation Programs

  • Hepatitis C (A Aronsohn and H Vargas, Section Editors)
  • Published:
Current Hepatology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Solid organ transplantation is the treatment of choice for many patients with end organ damage. Hepatitis C (HCV) infection is prevalent among solid organ candidates and recipients and remains to be a significant source of morbidity and mortality for this population. New therapies are currently available for this population. In the following review, we will outline HCV treatment strategies in non-liver transplantation candidates and recipients.

Recent Findings

Direct-acting antivirals (DAAs) have drastically modified the treatment landscape of HCV. New DAA agents have been studied in patients with chronic diseases, transplantation candidates, and transplantation recipients.

Summary

The safety and efficacy of DAAs in patients awaiting liver transplantation and liver transplantation recipients has provided us with guidance on how to use them effectively for patients who received or are awaiting non-liver solid organ transplantations.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

Abbreviations

HCV:

Hepatitis C virus

DAAs:

Direct-acting antiviral agents

ESKD:

End-stage kidney disease

HD:

Hemodialysis

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Younossi ZM, Kanwal F, Saab S, Brown KA, El-Serag HB, Kim WR, et al. The impact of hepatitis C burden: an evidence-based approach. Aliment Pharmacol Ther. 2014;39(5):518–31.

    Article  CAS  PubMed  Google Scholar 

  2. El-Serag HB, Anand B, Richardson P, Rabeneck L. Association between hepatitis C infection and other infectious diseases: a case for targeted screening? Am J Gastroenterol. 2003;98(1):167–74.

    Article  PubMed  Google Scholar 

  3. Davis GL, Alter MJ, El-Serag H, Poynard T, Jennings LW. Aging of hepatitis C virus (HCV)-infected persons in the United States: a multiple cohort model of HCV prevalence and disease progression. Gastroenterology. 2010;138(2):513–21, e1–6.

    Article  PubMed  Google Scholar 

  4. Fabrizi F, Verdesca S, Messa P, Martin P. Hepatitis C virus infection increases the risk of developing chronic kidney disease: a systematic review and meta-analysis. Dig Dis Sci. 2015;60(12):3801–13.

    Article  PubMed  Google Scholar 

  5. Tabatabaei SV, Alavian SM, Keshvari M, Behnava B, Miri SM, Karimi Elizee P, et al. Low dose ribavirin for treatment of hepatitis C virus infected thalassemia major patients; new indications for combination therapy. Hepat Mon. 2012;12(6):372–81.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Su Y, Norris JL, Zang C, Peng Z, Wang N. Incidence of hepatitis C virus infection in patients on hemodialysis: a systematic review and meta-analysis. Hemodial Int. 2013;17(4):532–41.

    PubMed  Google Scholar 

  7. Baid-Agrawal S, Pascual M, Moradpour D, Frei U, Tolkoff-Rubin N. Hepatitis C virus infection in haemodialysis and kidney transplant patients. Rev Med Virol. 2008;18(2):97–115.

    Article  PubMed  Google Scholar 

  8. Hajiani E, Masjedizadeh R, Hashemi J, Azmi M, Rajabi T. Hepatis C virus transmission and its risk factors within families of patients infected with hepatitis C virus in southern Iran: Khuzestan. World J Gastroenterol. 2006;12(43):7025–8.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Soleimani Amiri S, Shafaee S, Hasanjani Roushan MR, Baiani M, Hajiahmadi M. Evaluation of the need for treatment on 72 subjects with anti-HBe positive chronic hepatitis B. Caspian J Intern Med. 2012;3(4):519–22.

    PubMed  PubMed Central  Google Scholar 

  10. • Roth D, Nelson DR, Bruchfeld A, Liapakis A, Silva M, Monsour H Jr, et al. Grazoprevir plus elbasvir in treatment-naive and treatment-experienced patients with hepatitis C virus genotype 1 infection and stage 4–5 chronic kidney disease (the C-SURFER study): a combination phase 3 study. Lancet (London, England). 2015;386(10003):1537–45. One of several important studies that investigated HCV treatments in patients with CKD and/or post kidney transplantation.

  11. • Gane E, Lawitz E, Pugatch D, Papatheodoridis G, Brau N, Brown A, et al. Glecaprevir and pibrentasvir in patients with HCV and severe renal impairment. N Engl J Med. 2017;377(15):1448–55. One of several important studies that investigated HCV treatments in patients with CKD and/or post kidney transplantation.

  12. Kamar N, Chatelut E, Manolis E, Lafont T, Izopet J, Rostaing L. Ribavirin pharmacokinetics in renal and liver transplant patients: evidence that it depends on renal function. Am J Kidney Dis. 2004;43(1):140–6.

    Article  CAS  PubMed  Google Scholar 

  13. • Aqel BA, Vargas HE. Hepatitis C virus infection in nonliver solid organ transplant candidates and recipients. Curr Opin Org Transplant. 2015;20(3):259–66. One of several important studies that investigated HCV treatments in patients with CKD and/or post kidney transplantation.

  14. • Chascsa DMMO, Pungpapong S, Zhang N, Chervenak A, Nidaminuri S, Rodriguez EA, et al. Impact of HCV treatment before vs. after renal transplantation on time from listing to transplantation: a multi-center study. Hepatology (Baltimore, Md). 2017;66(S1):114A. One of several important studies that investigated HCV treatments in patients with CKD and/or post kidney transplantation.

  15. Schnitzler MA, Lentine KL, Burroughs TE. The cost effectiveness of deceased organ donation. Transplantation. 2005;80(11):1636–7.

    Article  PubMed  Google Scholar 

  16. Axelrod DA, Dzebisashvili N, Lentine K, Segev DL, Dickson R, Tuttle-Newhall E, et al. Assessing variation in the costs of care among patients awaiting liver transplantation. Am J Transplant. 2014;14(1):70–8.

    Article  CAS  PubMed  Google Scholar 

  17. Axelrod DA, Lentine KL, Xiao H, Bubolz T, Goodman D, Freeman R, et al. Accountability for end-stage organ care: implications of geographic variation in access to kidney transplantation. Surgery. 2014;155(5):734–42.

    Article  PubMed  Google Scholar 

  18. Kucirka LM, Singer AL, Ros RL, Montgomery RA, Dagher NN, Segev DL. Underutilization of hepatitis C-positive kidneys for hepatitis C-positive recipients. Am J Transplant. 2010;10(5):1238–46.

    Article  CAS  PubMed  Google Scholar 

  19. • Goldberg DS, Abt PL, Blumberg EA, Van Deerlin VM, Levine M, Reddy KR, et al. Trial of transplantation of HCV-infected kidneys into uninfected recipients. N Engl J Med. 2017;376(24):2394–5. One of several important studies that investigated HCV treatments in patients with CKD and/or post kidney transplantation.

  20. Baid-Agrawal S, Pascual M, Moradpour D, Somasundaram R, Muche M. Hepatitis C virus infection and kidney transplantation in 2014: what’s new? Am J Transplant. 2014;14(10):2206–20.

    Article  CAS  PubMed  Google Scholar 

  21. •• Colombo M, Aghemo A, Liu H, Zhang J, Dvory-Sobol H, Hyland R, et al. Treatment with ledipasvir-sofosbuvir for 12 or 24 weeks in kidney transplant recipients with chronic hepatitis C virus genotype 1 or 4 infection: a randomized trial. Ann Intern Med. 2017;166(2):109–17. One of several important studies that investigated HCV treatments in patients with CKD and/or post kidney transplantation.

    Article  PubMed  Google Scholar 

  22. •• Sawinski D, Kaur N, Ajeti A, Trofe-Clark J, Lim M, Bleicher M, et al. Successful treatment of hepatitis C in renal transplant recipients with direct-acting antiviral agents. Am J Transplant. 2016;16(5):1588–95. One of several important studies that investigated HCV treatments in patients with CKD and/or post kidney transplantation.

    Article  CAS  PubMed  Google Scholar 

  23. • Kamar N, Marion O, Rostaing L, Cointault O, Ribes D, Lavayssiere L, et al. Efficacy and safety of sofosbuvir-based antiviral therapy to treat hepatitis C virus infection after kidney transplantation. Am J Transplant. 2016;16(5):1474–9. One of several important studies that investigated HCV treatments in patients with CKD and/or post kidney transplantation.

    Article  CAS  PubMed  Google Scholar 

  24. • Hussein NR, Saleem ZS. Successful treatment of hepatitis C virus genotype 4 in renal transplant recipients with direct-acting antiviral agents. Am J Transplant. 2016;16(7):2237–8. One of several important studies that investigated HCV treatments in patients with CKD and/or post kidney transplantation.

    Article  CAS  PubMed  Google Scholar 

  25. •• Saxena V, Khungar V, Verna EC, Levitsky J, Brown RS Jr, Hassan MA, et al. Safety and efficacy of current direct-acting antiviral regimens in kidney and liver transplant recipients with hepatitis C: Results from the HCV-TARGET study. Hepatology (Baltimore, Md). 2017;66(4):1090–101. One of several important studies that investigated HCV treatments in patients with CKD and/or post kidney transplantation.

    Article  CAS  Google Scholar 

  26. Cano O, Almenar L, Martinez-Dolz L, Moro J, Izquierdo MT, Aguero J, et al. Course of patients with chronic hepatitis C virus infection undergoing heart transplantation. Transplant Proc. 2007;39(7):2353–4.

    Article  CAS  PubMed  Google Scholar 

  27. Lee I, Localio R, Brensinger CM, Blumberg EA, Lautenbach E, Gasink L, et al. Decreased post-transplant survival among heart transplant recipients with pre-transplant hepatitis C virus positivity. J Heart Lung Transplant. 2011;30(11):1266–74.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Kim EY, Ko HH, Yoshida EM. A concise review of hepatitis C in heart and lung transplantation. Can J Gastroenterol. 2011;25(8):445–8.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Fagiuoli S, Minniti F, Pevere S, Farinati F, Burra P, Livi U, et al. HBV and HCV infections in heart transplant recipients. J Heart Lung Transplant. 2001;20(7):718–24.

    Article  CAS  PubMed  Google Scholar 

  30. Fong TL, Hou L, Hutchinson IV, Cicciarelli JC, Cho YW. Impact of hepatitis C infection on outcomes after heart transplantation. Transplantation. 2009;88(9):1137–41.

    Article  PubMed  Google Scholar 

  31. Haji SA, Starling RC, Avery RK, Mawhorter S, Tuzcu EM, Schoenhagen P, et al. Donor hepatitis-C seropositivity is an independent risk factor for the development of accelerated coronary vasculopathy and predicts outcome after cardiac transplantation. J Heart Lung Transplant. 2004;23(3):277–83.

    Article  PubMed  Google Scholar 

  32. • Liu CH, Chen YS, Wang SS, Liu CJ, Su TH, Yang HC, et al. Sofosbuvir-based interferon-free direct acting antiviral regimens for heart transplant recipients with chronic hepatitis C virus infection. Clin Infect Dis 2017. One of several important studies that investigated HCV treatments in patients with CKD and/or post kidney transplantation.

  33. Poordad FF, Fabrizi F, Martin P. Hepatitis C infection associated with renal disease and chronic renal failure. Semin Liver Dis. 2004;24(Suppl 2):69–77.

    Article  PubMed  Google Scholar 

  34. • Woolley AE, Baden LR. Increasing access to thoracic organs from donors infected with hepatitis C: a previous challenge—now an opportunity. J Heart Lung Transplant 2017. One of several important studies that investigated HCV treatments in patients with CKD and/or post kidney transplantation.

  35. • Stepanova M, Locklear T, Rafiq N, Mishra A, Venkatesan C, Younossi ZM. Long-term outcomes of heart transplant recipients with hepatitis C positivity: the data from the U.S. transplant registry. Clin Transpl. 2016;30(12):1570–7. One of several important studies that investigated HCV treatments in patients with CKD and/or post kidney transplantation.

  36. Carbone M, Mutimer D, Neuberger J. Hepatitis C virus and nonliver solid organ transplantation. Transplantation. 2013;95(6):779–86.

    Article  PubMed  Google Scholar 

  37. • Khan B, Singer LG, Lilly LB, Chaparro C, Martinu T, Juvet S, et al. Successful lung transplantation from hepatitis C positive donor to seronegative recipient. Am J Transplant. 2017;17(4):1129–31. One of several important studies that investigated HCV treatments in patients with CKD and/or post kidney transplantation.

  38. • Theodoropoulos N, Whitson BA, Martin SI, Pouch S, Pope- Harman A. Successful treatment of donor-derived hepatitis C infection in a lung transplant recipient. Transplant infectious disease 2017; 19(2). One of several important studies that investigated HCV treatments in patients with CKD and/or post kidney transplantation.

  39. • D'Ambrosio R, Aghemo A, Rossetti V, Carrinola R, Colombo M. Sofosbuvir-based regimens for the treatment of hepatitis C virus in patients who underwent lung transplant: case series and review of the literature. Liver Int. 2016;36(11):1585–9. One of several important studies that investigated HCV treatments in patients with CKD and/or post kidney transplantation.

  40. • Koenig A, Stepanova M, Saab S, Ahmed A, Wong R, Younossi ZM. Long-term outcomes of lung transplant recipients with hepatitis C infection: a retrospective study of the U.S. transplant registry. Aliment Pharmacol Ther. 2016;44(3):271–8. One of several important studies that investigated HCV treatments in patients with CKD and/or post kidney transplantation.

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Bashar A. Aqel.

Ethics declarations

Conflict of Interest

Eduardo A. Rodriguez and Bashar A. Aqel declare no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Hepatitis C

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rodriguez, E.A., Aqel, B.A. Hepatitis C Virus Treatment in Non-Liver Organ Transplantation Programs. Curr Hepatology Rep 17, 105–110 (2018). https://doi.org/10.1007/s11901-018-0393-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11901-018-0393-y

Keywords

Navigation