Evaluation of Different Regimens of New Direct Acting Antiviral drugs (DAAs) for treatment of Recurrent Hepatitis C Virus Infection after Liver Transplantation

Abstract

It is well established that HCV is of global importance. The HCV epidemic affects about 2.35% of the worldwide population. The number of HCV-related cirrhosis cases is estimated to increase by 24% and that of decompensated cirrhosis cases by 50%. The highest HCV prevalence in the world occurs in Egypt and is estimated to be 12% among the general population and reaches 40% in persons 40 years of age and above in rural areas. HCV Genotype 4 is the predominant genotype in Egypt. Liver transplantation is the best treatment for patients with end-stage liver disease. This mode of treatment gives the recipient a chance to have a new and almost normal liver, as well as freedom from the previous disease. With the marked evolution in surgical and anesthetic techniques, development of organ preservation solutions and advances in immunology, outcomes for liver transplantation have improved over time. Before liver transplantation, there was little to offer patients with advanced liver disease with features of decompensation such ascites, hepatorenal syndrome, hepatic encephalopathy, spontaneous bacterial peritonitis, gastro-oesophageal variceal bleeding and hepatocellular carcinoma. These patients had a sinister prognosis because only symptomatic therapy was offered. The advent of OLT as an accepted therapy for advanced