Pathogenesis of recurrent hepatitis C after liver transplantation

End-stage liver disease associated with hepatitis C virus (HCV) infection is the most common indication for liver transplantation in the United States. Recurrent HCV infection is nearly universal and disease progression is accelerated in the immunocompromised host. In the post-transplant setting, the HCV-specific immune response plays a critical role in viral surveillance and disease progression. A failure to mount an efficient response to HCV antigens, either because of selective defects in the host immune system or because of viral interference with the normal function of the immune cells, could account for the inability of most transplant recipients to eradicate HCV.