Treatment of Chronic Hepatitis C in HCV-Seronegative Patients Receiving a Liver Graft from an HCV-Viremic Donor
Transplanting a liver from an HCV RNA-positive donor into a recipient with no prior HCV infection creates a defined clinical scenario that requires a structured antiviral management plan from the earliest post-transplant days.
This protocol addresses HCV-seronegative recipients undergoing liver transplantation with a graft from an HCV-viremic (HCV RNA-positive) donor. Emerging data support initiating HCV treatment as early as possible in this setting — acting promptly following transplantation is a key principle of care.
Direct-acting antiviral (DAA) combination therapy is the recommended approach, with the timing of initiation relative to the transplant being a central management decision — the complete protocol specifies the regimen options and the preferred treatment window.
The primary clinical target is sustained virologic response 12 weeks after completion of therapy (SVR12) — confirmed by undetectable HCV RNA.
References
DOI: 10.1093/cid/ciad319
- Emerging data support HCV treatment as early as possible when transplanting an HCV-viremic liver graft into an HCV-seronegative recipient.
- The Guidance Panel recommends initiating therapy at least within 2 weeks after transplantation but preferably within 1 week when the patient is clinically stable.
- Timing: initiate treatment within the first 2 wk posttransplant, preferably within the first week.
- SVR12, sustained virologic response 12 weeks after completion of therapy.