title: Interferon-alpha plus ribavirin and amantadine in patients with post-transplant hepatitis C: results of a pilot study.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Cardioangiology and Hepatology, University of Bologna, Italy. andreone@med.unibo.it
authors.forename: P
authors.initials: P
authors.lastname: Andreone
authors.forename: A
authors.initials: A
authors.lastname: Gramenzi
authors.forename: C
authors.initials: C
authors.lastname: Cursaro
authors.forename: M
authors.initials: M
authors.lastname: Biselli
authors.forename: L
authors.initials: L
authors.lastname: Di Giammarino
authors.forename: G L
authors.initials: GL
authors.lastname: Grazi
authors.forename: E
authors.initials: E
authors.lastname: Jovine
authors.forename: A
authors.initials: A
authors.lastname: D'Errico
authors.forename: S
authors.initials: S
authors.lastname: Galli
authors.forename: A
authors.initials: A
authors.lastname: Mazziotti
authors.forename: A
authors.initials: A
authors.lastname: Cavallari
authors.forename: M
authors.initials: M
authors.lastname: Bernardi
mesh_terms: 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
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D012254:Ribavirin; D000547:Amantadine