**3.2.2 Late post-transplant antiviral therapy**

This consists of applying treatment once the histological recurrence of the HCV is well established, with the aim of preventing rapid progression of the hepatic lesion. The period of treatment application is from 2 to 7 months after the transplant, or according to the histological lesions seen on liver biopsy. Using this strategy, the patient has a lower and better controlled degree of immunosuppression, has recovered from the surgery, and alterations present prior to the transplant have been corrected, such as anaemia, thrombocytopoenia or the nutritional status, all of which favour greater tolerance and applicability.

The rate of sustained viral response seen with this schedule is from 20% to 40% (2,21-22,25); the rate of premature interruption of treatment is around 28% and that of dose reduction 73%. The results, though, are still worse than those found in immunocompetent patients (Berenguer, 2008).

In all cases management should be personalized, and consideration given to such factors as renal function, concomitant diabetes, a prior history of rejection and genotype (Aymant et al, 2010).
