Anil Chandra Anand, Professor, Department of Gastroenterology and Hepatology, Kalinga Institute of Medical Sciences, KIIT Campus, Patia, Bhubaneswar 751024, Odisha, India. anilcanand@gmail.com
Research Domain of This Article
Virology
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Dibya Lochan Praharaj, Suprabhat Giri, Anil Chandra Anand, Bipadabhanjan Mallick, Preetam Nath, Saroj Kanta Sahu, Subrat Kumar Acharya, Yogesh Kumar Chawla, Department of Gastroenterology and Hepatology, Kalinga Institute of Medical Sciences, Bhubaneswar 751024, Odisha, India
Bramhadatta Pattnaik, Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Bhubaneshwar 751019, Odisha, India
Author contributions: Praharaj DL, Giri S and Anand AC wrote the first draft; Praharaj DL, Giri S, Anand AC, Mallick B, and Nath P revised the manuscript; all authors participated in additional discussions and revision of the manuscript.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
Corresponding author: Anil Chandra Anand, Professor, Department of Gastroenterology and Hepatology, Kalinga Institute of Medical Sciences, KIIT Campus, Patia, Bhubaneswar 751024, Odisha, India. anilcanand@gmail.com
Received: September 18, 2025 Revised: November 22, 2025 Accepted: December 25, 2025 Published online: March 25, 2026 Processing time: 176 Days and 14.6 Hours
Core Tip
Core Tip: Effective management of viral hepatitis after liver transplantation hinges on early diagnosis, vigilant monitoring, and timely antiviral therapy. For hepatitis B virus, nucleos(t)ide analogues with high genetic barriers to resistance (e.g., entecavir, tenofovir alefnamide/tenofovir disoproxyl fumarate) are preferred, often with short-term hepatitis B immunoglobulin in high-risk patients. Directly acting antivirals have revolutionized treatment of patients with hepatitis C virus infection. Though timing of treatment must balance the baseline model for end stage liver disease score and graft outcomes. Hepatitis E virus infection should be suspected in unexplained graft dysfunction; ribavirin is effective when reduction of immunosupression fails. Recurrence with hepatitis D virus infection is rare if hepatitis B virus is well controlled. Infection with cytomegalovirus and Epstein-Barr virus require prophylaxis, pre-emptive monitoring, and individualized immunosuppression adjustment to reduce risk of post-transplant lymphoproliferative disorder (related to Epstein-Barr virus infection) and graft loss.
