Pipili Chrysoula, Cholongitas Evangelos
Chrysoula Pipili, Division of Nephrology, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, Scotland, United Kingdom.
World J Gastrointest Pharmacol Ther. 2015 Nov 6;6(4):105-10. doi: 10.4292/wjgpt.v6.i4.105.
The combination of hepatitis B immune globulin with entecavir or tenofovir (at least for a certain period of time) seems to be the most reasonable prophylaxis against recurrent hepatitis B after liver transplantation. Entecavir represents an attractive option for treatment of naïve kidney transplant recipients, because of its high efficacy and the low rates of resistance. However antiviral treatment should be individualized in the view of kidney function and the previous resistance. To date, new captivating therapeutic strategies could make interferon-free regimens viable for treatment of hepatitis C virus positive liver transplant recipients. The recent combinations of sofosbuvir with simeprevir or daclatasvir or ledipasvir plus/minus ribavirin have boosted the on treatment and sustained virological response to rates approaching 100% within liver transplant recipients with recurrent chronic hepatitis C (CHC). Preliminary data showed that the second generation direct oral antivirals could result to high treatment rates of recurrent CHC in kidney transplant recipients as well. Ongoing studies will clarify the optimal treatment of recurrent CHC in kidney transplant recipients.
乙肝免疫球蛋白与恩替卡韦或替诺福韦联合使用（至少在一段时间内）似乎是肝移植后预防乙肝复发最合理的方法。恩替卡韦因其高效和低耐药率，是初治肾移植受者治疗的一个有吸引力的选择。然而，抗病毒治疗应根据肾功能和既往耐药情况进行个体化。迄今为止，新的引人注目的治疗策略可使无干扰素方案用于丙型肝炎病毒阳性肝移植受者的治疗成为可能。索磷布韦与simeprevir或达卡他韦或来迪帕司韦加/减利巴韦林的近期联合使用，已使复发性慢性丙型肝炎（CHC）肝移植受者的治疗中和持续病毒学应答率提高到接近100%。初步数据表明，第二代直接口服抗病毒药物在肾移植受者复发性CHC中也可实现高治疗率。正在进行的研究将阐明肾移植受者复发性CHC的最佳治疗方法。
