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10.3390/jcm15010346
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

Treatment with Direct-Acting Antivirals in Patients with HCV Infection After Liver Transplantation

by
Michał Brzdęk
1,2,*,
Dorota Zarębska-Michaluk
3,
Olga Tronina
4,
Łukasz Laurans
5,6,
Ewa Janczewska
7,
Dorota Dybowska
8,
Anna Parfieniuk-Kowerda
9,
Magdalena Tudrujek-Zdunek
10,
Jolanta Białkowska-Warzecha
11,
Justyna Janocha-Litwin
12 and
Robert Flisiak
9
1
Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland
2
Department of Gastroenterology, Medical University of Lodz, 92-213 Lodz, Poland
3
Department of Infectious Diseases and Allergology, Collegium Medicum, Jan Kochanowski University, 25-317 Kielce, Poland
4
Lazarski University, 02-662 Warsaw, Poland
5
Department of Infectious Diseases, Hepatology and Liver Transplantation, Pomeranian Medical University, 70-204 Szczecin, Poland
6
Multidiscyplinary Voivodship Hospital, 66-400 Gorzów Wlkp, Poland
7
ID Clinic, 41-400 Mysłowice, Poland
8
Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, 85-030 Bydgoszcz, Poland
9
Department of Infectious Diseases and Hepatology, Medical University of Bialystok, 15-540 Białystok, Poland
10
Department of Infectious Diseases, Medical University of Lublin, 20-059 Lublin, Poland
11
Biegański Regional Specjalist Hospital, 91-347 Łódź, Poland
12
Infectious Diseases and Hepatology Clinic, Medical University of Wroclaw, 50-367 Wrocław, Poland
 
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*
Author to whom correspondence should be addressed.
J. Clin. Med. 2026, 15(1), 346; https://doi.org/10.3390/jcm15010346
Submission received: 6 October 2025 / Revised: 4 December 2025 / Accepted: 30 December 2025 / Published: 2 January 2026
(This article belongs to the Special Issue Advances in Hepatitis: Prevention, Treatment, and Global Health Impact)
Versions Notes

Abstract

Background/Objectives: Direct-acting antivirals (DAAs) have revolutionized the management of chronic hepatitis C virus (HCV) infection. However, real-world data on the effectiveness and safety of DAA therapy in patients with history orthotopic liver transplantation (OLTx) remain limited. This study aimed to evaluate the clinical characteristics, effectiveness, and safety of DAA therapy in liver transplant recipients with chronic hepatitis C in a nationwide, real-world cohort. Methods: A retrospective analysis was performed of all consecutive adult patients who underwent OLTx before starting DAA therapy between July 2015 and December 2024 within the EpiTer-2 project, which included 20,586 patients treated because of chronic hepatitis C. Results: A total of 141 patients participated in the study, with most of them being men (66%) and aged 50 years or older. Most patients (80%) had comorbidities, and nearly a quarter of the population had cirrhosis of the transplanted liver at the start of antiviral therapy. The median time from OLTx to initiation of antiviral therapy was 24 months. Overall, SVR was achieved in 96.4% of patients in the intention-to-treat analysis and in 98.6% after excluding patients lost to follow-up. The treatment was well tolerated. Serious adverse events were reported in five patients. During DAA treatment and 12 weeks of follow-up after treatment, two deaths were reported. Subgroup analysis by time from OLTx to antiviral therapy (≤24 vs. >24 months) revealed no differences in effectiveness and safety despite some baseline clinical variations. Conclusions: DAA therapy in liver transplant recipients with chronic HCV infection is highly effective and well-tolerated.
Keywords: chronic hepatitis C; hepatitis C virus; liver transplantation; direct-acting antivirals chronic hepatitis C; hepatitis C virus; liver transplantation; direct-acting antivirals

Share and Cite

MDPI and ACS Style

Brzdęk, M.; Zarębska-Michaluk, D.; Tronina, O.; Laurans, Ł.; Janczewska, E.; Dybowska, D.; Parfieniuk-Kowerda, A.; Tudrujek-Zdunek, M.; Białkowska-Warzecha, J.; Janocha-Litwin, J.; et al. Treatment with Direct-Acting Antivirals in Patients with HCV Infection After Liver Transplantation. J. Clin. Med. 2026, 15, 346. https://doi.org/10.3390/jcm15010346

AMA Style

Brzdęk M, Zarębska-Michaluk D, Tronina O, Laurans Ł, Janczewska E, Dybowska D, Parfieniuk-Kowerda A, Tudrujek-Zdunek M, Białkowska-Warzecha J, Janocha-Litwin J, et al. Treatment with Direct-Acting Antivirals in Patients with HCV Infection After Liver Transplantation. Journal of Clinical Medicine. 2026; 15(1):346. https://doi.org/10.3390/jcm15010346

Chicago/Turabian Style

Brzdęk, Michał, Dorota Zarębska-Michaluk, Olga Tronina, Łukasz Laurans, Ewa Janczewska, Dorota Dybowska, Anna Parfieniuk-Kowerda, Magdalena Tudrujek-Zdunek, Jolanta Białkowska-Warzecha, Justyna Janocha-Litwin, and et al. 2026. "Treatment with Direct-Acting Antivirals in Patients with HCV Infection After Liver Transplantation" Journal of Clinical Medicine 15, no. 1: 346. https://doi.org/10.3390/jcm15010346

APA Style

Brzdęk, M., Zarębska-Michaluk, D., Tronina, O., Laurans, Ł., Janczewska, E., Dybowska, D., Parfieniuk-Kowerda, A., Tudrujek-Zdunek, M., Białkowska-Warzecha, J., Janocha-Litwin, J., & Flisiak, R. (2026). Treatment with Direct-Acting Antivirals in Patients with HCV Infection After Liver Transplantation. Journal of Clinical Medicine, 15(1), 346. https://doi.org/10.3390/jcm15010346

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