Purpose of review: To give a comprehensive update of the current hepatitis C (HCV) antiviral treatments in the liver transplant setting.
Recent findings: Hepatitis C treatment after liver transplantation with several interferon-free combinations has shown excellent efficacy and safety results, overwhelming interferon-based therapies in this setting. In posttransplant decompensated liver disease, however, efficacy of antiviral therapies seems to be lower, but viral eradication has been associated with an improvement of liver function and clinical status in most cases. Hence, antiviral treatment should be offered before advanced liver disease is reached, in order to prevent graft damage and guarantee the best efficacy rates of therapies.
Summary: New interferon-free combinations with potent direct antivirals cure hepatitis C in most of patients after liver transplantation. Hepatitis C after liver transplantation should be treated as early as possible and before advanced liver disease is established in the graft. In patients with graft cirrhosis, eradication of hepatitis C is associated with improved liver function.