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JAC Advance Access published online on June 9, 2004
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkh297
© 2004 by The British Society for Antimicrobial Chemotherapy
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Received February 19, 2004
Revised April 2, 2004
Accepted April 23, 2004

Leading article

Recurrent hepatitis C virus infection after liver transplantation: natural course, therapeutic approach and possible mechanisms of viral control

Norbert Hubert Gruener 1, Maria-Christina Jung 1, Carl Albrecht Schirren 1*

1 Department of Medicine II, Klinikum Grosshadern, University of Munich, Marchioninistrasse 15, D-81377 Munich, Germany; Institute for Immunology, University of Munich, Goethestrasse 31, D-80336 Munich, Germany

* To whom correspondence should be addressed. E-mail: carl.albrecht.schirren{at}med.uni-muenchen.de.


  Abstract

End-stage liver disease associated with hepatitis C virus (HCV) infection has become the leading indication for liver transplantation worldwide. The new transplant liver is infected in nearly all patients, but the disease progression is highly variable. Although short-term survival appears to be similar to that in other causes of liver failure, progression to HCV-related cirrhosis is estimated to reach 20-30% at 5 year follow-up. Identification of factors that influence disease progression is important to optimize results of current treatment. This review summarizes the natural history, therapeutic options and future therapeutic strategies aimed at the induction and reinforcement of an adequate virus-specific CD4+T cell response.

Key Words: Keywords: T cells, ELISpot assay, interferon, ribavirin, antiviral therapy


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