title: Amantadine therapy in renal transplant patients with hepatitis C virus infection.
abstract: BACKGROUND
  To date, there is no safe and efficient treatment of hepatitis C virus (HCV) infection after renal transplantation. Recently, there were encouraging reports after using amantadine in HCV-positive immunocompetent patients.
  
  
  OBJECTIVE
  In an open pilot study, we evaluated the efficacy and the safety of amantadine monotherapy in 8 HCV positive renal-transplant patients with chronic active hepatitis and increased alanine aminotransferase (ALT) levels.
  
  
  RESULTS
  After 6 months of amantadine therapy (200 mg per day), there were no decrease in HCV viremia (5.87 +/- 0.37 log copies/ml at M6 versus 5.71 +/- 0.5 log copies/ml at baseline; P > 0.05). However, we found a significant decrease in ALT activity (71 +/- 17 IU/l at M6 versus 100 +/- 9 IU/l at baseline; P = 0.04), whereas the decrease in aspartate aminotransferase activity did not reach statistical significance. There were no significant changes in liver histology. The clinical and biological tolerance was very good. Finally, there were a significant decrease in cyclosporine A whole blood trough levels during therapy.
  
  
  CONCLUSIONS
  Our study is the first one to demonstrate that amantadine monotherapy lack of efficacy in HCV renal-transplant patients. It is able to improve liver enzymes but it has no impact neither upon HCV viremia nor upon liver histology.
authors.affiliation: Department of Nephrology, Dialysis and Transplantation, CHU Toulouse-Rangueil, TSA 50032, 31059 Toulouse Cedex 9, France. kamar.n@chu-toulouse.fr
authors.forename: Nassim
authors.initials: N
authors.lastname: Kamar
authors.forename: Lionel
authors.initials: L
authors.lastname: Rostaing
authors.forename: Karine
authors.initials: K
authors.lastname: Sandres-Saune
authors.forename: David
authors.initials: D
authors.lastname: Ribes
authors.forename: Dominique
authors.initials: D
authors.lastname: Durand
authors.forename: Jacques
authors.initials: J
authors.lastname: Izopet
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D000547:Amantadine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000998:Antiviral Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001219:Aspartate Aminotransferases / Q000097:blood; D016572:Cyclosporine / Q000097:blood; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000473:pathology / Q000821:virology; D006801:Humans; D016867:Immunocompromised Host; D016030:Kidney Transplantation; D008099:Liver / Q000473:pathology; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood; D019562:Viral Load; D014766:Viremia
chemical_list: D000998:Antiviral Agents; D012367:RNA, Viral; D016572:Cyclosporine; D000547:Amantadine; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase