Hepatocellular carcinoma in the wait-listed patient with hepatitis C virus

Stacey B. Prenner, Laura Kulik*

*Corresponding author for this work

Research output: Contribution to journalReview article

1 Scopus citations

Abstract

Purpose of review To highlight the current data for treatment of hepatitis C virus (HCV) in patients with hepatocellular carcinoma (HCC) awaiting orthotopic liver transplant and incorporation of various factors to decide the optimal time to initiate HCV therapy. Recent findings Viral eradication on the waiting list has been found to lead to significant clinical improvement in approximately 20% of HCV-positive patients. However, there have been concerns raised for direct-acting antiviral (DAA) therapy in patients listed with HCC. DAA therapy leading to rapid HCV clearance has been reported to be associated with an increased risk of HCC recurrence, especially when DAA therapy is initiated in close proximity to HCC therapy. Additionally, the presence of viable HCC may significantly lower the chances of achieving sustained virologic response. Lastly, sustained virologic response can decrease the organ pool in HCV-positive waitlisted patients. Summary The decision to treat HCV in patients listed for HCC pre vs. postliver transplant will require additional research.

Original languageEnglish (US)
Pages (from-to)237-243
Number of pages7
JournalCurrent opinion in organ transplantation
Volume23
Issue number2
DOIs
StatePublished - Apr 2018

Keywords

  • Directing antiviral agents
  • Hepatitis C
  • Hepatocellular carcinoma
  • Recurrence
  • Wait list

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation

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