Recurrent hepatitis C virus infection post liver transplantation: Impact of choice of calcineurin inhibitor

Christophe Duvoux, Roberto Firpi, Gian L. Grazi, Gary Levy, Eberhard Renner, Federico Villamil

Research output: Contribution to journalArticlepeer-review


Recurrence of hepatitis C virus infection following liver transplantation (LT) for hepatitis C is universal. After LT, hepatitis C is associated with accelerated fibrosis progression and reduced graft and patient survival. Furthermore, responses to antiviral therapy in patients with recurrent hepatitis C virus post-transplant are consistently sub-optimal. Calcineurin inhibitors (CNIs) like cyclosporine A (CsA) and tacrolimus continue to dominate immunosuppressive regimens in this population; however, there is still uncertainty as to whether either offers an advantage in terms of patient outcomes. Although tacrolimus demonstrates improved efficacy in the general LT population, differences have begun to emerge between these agents regarding diabetogenic potential, antiviral activity, and fibrosis progression in patients with hepatitis C. This review critically evaluates the existing literature, providing an overview of the reported differences, concluding that despite conflicting evidence, a potential benefit of CsA in patients with hepatitis C is supported by the data and warrants further investigation. Future studies examining the role of CNIs in hepatitis C virus-positive LT recipients are required to accurately examine the effects of CNIs on outcomes such as fibrosis progression, survival, and effects on response to antiviral therapy, to provide robust information that allows clinicians to make an informed choice concerning which CNI is best for their patients.

Original languageEnglish
Pages (from-to)358-372
Number of pages15
JournalTransplant International
Issue number4
Publication statusPublished - Apr 2013


  • calcineurin inhibitor
  • cyclosporine A
  • HCV
  • liver transplantation

ASJC Scopus subject areas

  • Transplantation


Dive into the research topics of 'Recurrent hepatitis C virus infection post liver transplantation: Impact of choice of calcineurin inhibitor'. Together they form a unique fingerprint.

Cite this