cyclosporine and hepatitis c环孢霉素和丙型肝炎.pdfVIP

Open Journal of Organ Transplant Surgery, 2012, 2, 32-36 /10.4236/ojots.2012.24009 Published Online November 2012 (http://www.SciRP.org/journal/ojots) Cyclosporine and Hepatitis C 1 2* Ryan Caballes , Mark W. Russo 1Department of Medicine, Carolinas Medical Center, Charlotte, USA 2Carolinas Medical Center, Charlotte, USA * Email: Mark.Russo@ Received September 24, 2012; revised October 27, 2012; accepted November 7, 2012 ABSTRACT End stage liver disease from hepatitis C is a leading indication for liver transplantation. Recurrent hepatitis C after liver transplant may lead to cirrhosis and graft failure in up to 25% of recipients five years after liver transplantation. Antivi- ral therapy is challenging after liver transplantation due to increased side effects including cytopenias and decreased efficacy compared to the nontransplant population. Tacrolimus and cyclosporine are the most common immunosup- pressants used to prevent graft rejection. Tacrolimus is more potent than cyclosporine and may be preferred to cyc- losporine. However, cyclosporine may have activity against hepatitis C and may have a theoretical advantage to tac- rolimus in hepatitis liver transplant recipients. Cyclosporine may inhibit NS5B and NS5A protein complexes and in- crease endogenous interferon activity. Cyclophilin inhibitors without immunosuppressive properties are under devel- opment and represent a novel mechanisms for inhibiting HCV replication. Keywords: Immunosuppression; Liver; Transplant 1. Introductio