Direct-acting antiviral drugs against hepatitis C virus in renal transplant recipients: Is it the dawn of an interferon-free Era?

Hepatitis C virus (HCV) is a significant problem among hemodialysis population, especially in India where renal transplant often gets delayed in the presence of live-related donors. An acceleration of liver cirrhosis and poor renal allograft outcomes are often witnessed in allograft recipients with high viral load. Use of interferon in the postrenal transplant setting for the treatment of hepatitis C viral infection was limited to a few grave situations, fearing the precipitation of allograft rejection and poor efficacy for sustained virological remission. However, the availability of newer direct-acting antivirals has opened a new tool box in the management of HCV in the postrenal transplant setting and in reducing the pretransplant waiting period.