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      HCV Antiviral Therapy in Liver Transplant Candidates and Recipients With Renal Insufficiency.

      1 ,
      Transplantation
      Ovid Technologies (Wolters Kluwer Health)

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          Abstract

          Hepatitis C virus (HCV) remains the leading indication for liver transplant in much of the world and has traditionally been associated with diminished posttransplant survival due to recurrent HCV-related liver disease. This field has been dramatically changed by the advent of safe and effective direct-acting antiviral therapy, such that most patients can be cured in the pretransplant or posttransplant setting. In addition, there are now direct-acting antiviral regimens specifically approved for use in patients with severe renal insufficiency. However, patients with pre or posttransplant severe renal insufficiency remain more difficult to treat, due to mechanisms of drug metabolism in hepatic and renal failure, as well as posttransplant drug-drug interactions. Treatment options are even more restricted in non-1 HCV genotypes. Because renal insufficiency is common among patients with HCV, with decompensated cirrhosis, and in the posttransplant setting, this difficult scenario is relatively common. However, ongoing development of pangenotypic regimens with improved safety profiles, as well as additional data on dosing and safety among patients with severe renal insufficiency, will continue to expand options for cure even in these most difficult to treat patients.

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          Author and article information

          Journal
          Transplantation
          Transplantation
          Ovid Technologies (Wolters Kluwer Health)
          1534-6080
          0041-1337
          May 2017
          : 101
          : 5
          Affiliations
          [1 ] 1 Center for Liver Disease and Transplantation, New York Presbyterian Hospital, New York, NY.
          Article
          10.1097/TP.0000000000001688
          28212220
          27b8589e-6530-46d7-812e-216b0650631b
          History

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