Journal Article

Prevention of Fungal and Hepatitis Virus Infections in Liver Transplantation

Carlos V. Paya

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 33, issue Supplement_1, pages S47-S52
Published in print July 2001 | ISSN: 1058-4838
Published online July 2001 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/320904
Prevention of Fungal and Hepatitis Virus Infections in Liver Transplantation

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Invasive fungal infections, especially those caused by Candida albicans, and recurrence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection after transplantation are common complications in orthotopic liver transplant (OLT) recipients. Candida species account for >50% of all invasive fungal infections, which occur in 10%–15% of OLT recipients. The epidemiology and pathogenesis of invasive fungal infections are unique to each type of organism. Fluconazole is effective and safe in the prevention of Candida infection after OLT. Preventive measures against Aspergillus or Cryptococcus remain ill defined. Both HBV and HCV recur almost universally after OLT in infected individuals. The natural course of HBV and HCV, leading to end-stage liver damage, is accelerated. In OLT patients, administration of immunoglobulin with high titers against HBV, alone and/or in combination with lamivudine, immediately after transplantation reduces the recurrence of HBV. The combination of interferon and ribavirin is mildly effective in OLT patients who have evidence of recurrent hepatitis, and additional alternatives are being evaluated.

Journal Article.  4068 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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