Treatment of Chronic Hepatitis C After Liver or Kidney Transplantation

This protocol addresses patients with recurrent chronic hepatitis C infection following liver or kidney transplantation — specifically those without cirrhosis or with compensated cirrhosis.

Clinical Setting

Recurrent chronic hepatitis C arising in the post-transplant setting, following liver or kidney transplantation. Applies to patients without cirrhosis or with compensated cirrhosis at the time of treatment.

Treatment Goal

The primary target is sustained virologic response 12 weeks after completion of therapy (SVR12) — defined as undetectable HCV RNA at that time point.

Treatment Approach

Guideline-supported direct-acting antiviral combinations are available for this population, including pan-genotypic options covering the full range of HCV genotypes. Regimen selection is guided by genotype, transplant type, and individual patient factors.

The complete regimen — including specific drug combinations, genotype-based selection criteria, and resistance considerations — is detailed in the full structured protocol below.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1093/cid/ciad319

The phase 3, single-arm, open-label MAGELLAN-2 trial, titled "Glecaprevir/pibrentasvir treatment in liver or kidney transplant patients with hepatitis C virus infection" evaluated a 12-week course of once-daily glecaprevir (300 mg)/pibrentasvir (120 mg) for the treatment of HCV infection (genotypes 1 through 6) among patients without cirrhosis who had undergone liver or kidney transplantation and were ≥3 months posttransplantation.

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