Treatment of Chronic Hepatitis C in HCV-Seronegative Patients Receiving a Non-Liver Solid Organ Graft from an HCV-Viremic Donor
This protocol covers a defined transplant scenario: an HCV-seronegative recipient who is undergoing or has just undergone transplantation of a non-liver solid organ from a donor with active HCV viraemia (HCV RNA-positive). Donor-derived HCV transmission is a recognised risk in this setting, making early treatment intervention essential.
Clinical Situation
HCV treatment should occur as early as possible in HCV-seronegative patients who undergo transplantation with a non-liver graft from an HCV-viremic donor. The timing of treatment initiation — relative to the transplant procedure — is a defining feature of the management approach.
Therapeutic Goal
The primary endpoint is SVR12 — sustained virologic response confirmed by undetectable HCV RNA at 12 weeks after completing therapy.
Treatment Approach
Direct-acting antiviral (DAA) therapy is recommended, with the timing strategy — prophylactic (immediately before transplant) or preemptive (within the first week posttransplant when clinically stable) — being a key determinant of regimen selection and duration. The full protocol specifies agent choices, genotype coverage, duration criteria, and the decision rules that apply when initiation is delayed…
References
DOI: 10.1093/cid/ciad319
- HCV treatment should occur as early as possible in HCV-seronegative patients who undergo transplantation with a non-liver graft from an HCV-viremic donor.
- Use of a prophylactic (immediately prior to transplantation or day 0 posttransplantation) or preemptive (day 0 to day 7 posttransplantation; as soon as the patient is clinically stable) strategy for initiation of DAA treatment is recommended for HCV-negative recipients of a non-liver solid organ graft from an HCV-viremic donor.
- SVR12, sustained virologic response 12 weeks after completion of therapy.
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