Interferon-alpha plus ribavirin and amantadine in patients with post-transplant hepatitis C: results of a pilot study.
BACKGROUND
Recurrence of hepatitis C after liver transplantation is almost constant and may lead to graft loss. The results of treatment with interferon and/or other agents have been controversial.


OBJECTIVE
To evaluate the efficacy and safety of combination therapy with interferon-alpha2b (3 MU, 3 times weekly), ribavirin (600 mg daily) and amantadine (100 mg daily) in post-transplant hepatitis C.


METHODS
Enrolled in the study were 9 liver transplant recipients with histologically proven recurrent hepatitis C. Patients were treated for 12 months and followed up for 6 months after treatment.


RESULTS
Treatment was not tolerated: only one patient completed the planned course, two stopped therapy within the first 3 months and 6 needed a change. However, mean alanine aminotransferase levels significantly decreased during treatment and were significantly lower than baseline at the end of follow-up. One patient out of 9 (11%) achieved a biochemical and virological sustained response. Control liver biopsy showed improvement in 2/7 patients, no change in 3 and worsening in 2.


CONCLUSIONS
In recurrent post-transplant hepatitis C, antiviral treatment with interferon, ribavirin and amantadine seems to be poorly tolerated. However further studies are needed before expressing any conclusion on this potentially important option.
Andreone
P
P
Department of Internal Medicine, Cardioangiology and Hepatology, University of Bologna, Italy. andreone@med.unibo.it
Gramenzi
A
A
Cursaro
C
C
Biselli
M
M
Di Giammarino
L
L
Grazi
G L
GL
Jovine
E
E
D'Errico
A
A
Galli
S
S
Mazziotti
A
A
Cavallari
A
A
Bernardi
M
M
D000368:Aged; D000547:Amantadine / Q000627:therapeutic use*; D000998:Antiviral Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006526:Hepatitis C / Q000188:drug therapy*; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012008:Recurrence; D012254:Ribavirin / Q000627:therapeutic use*; D016896:Treatment Outcome
D000998:Antiviral Agents; D016898:Interferon-alpha; D012254:Ribavirin; D000547:Amantadine