Rimantadine for treatment of hepatitis C infection in liver transplant recipients

Hepatitis C recurrence after liver transplantation is a serious problem, le ading to increased graft loss and morbidity in some individuals, Treatment with interferon and other agents is controversial and not highly efficaciou s. The use of an effective antiviral agent to reduce or eliminate viral bur den is desirable, To this end, we performed an open-label pilot trial to de termine if rimantadine would show antiviral activity against hepatitis C vi rus (HCV) in the posttransplantation setting. Eleven patients with recurren t post-liver transplantation disease, characterized by transaminase level a bnormality and HCV RNA in serum and liver biopsy specimens consistent with HCV infection were offered enrollment onto the study, Patients were treated for 12 weeks with rimantadine, 100 mg orally twice daily, and followed up after treatment for up to 8 additional weeks, Serum was collected at 2-week intervals to assess transaminase and HCV RNA levels. Nine patients complet ed the planned course of therapy. There was no significant change in serum alanine aminotransferase levels during treatment, No patients cleared HCV R NA from the serum, and fluctuations in the viral titer were not clearly ass ociated with the initiation and completion of the active-treatment phase, R imantadine was well tolerated, with only one patient who stopped therapy fo r perceived side effects, We conclude that rimantadine monotherapy has no r ole in the management of recurrent hepatitis C after liver transplantation. Copyright (C) 1999 by the American Association for the Study of Liver Dise ases.