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 interfe ron and/or other agents have been controversial. Aims. To evaluate the efficacy and safety of combination therapy with inter feron-alpha (2b) (3 MU, 3 times weekly), ribavirin (EDO mg daily] and amant adine (100 mg daily) in post-transplant hepatitis C. Patients and Methods. Enrolled in the study were 9 liver transplant recipie nts 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 planne d course, two stopped therapy within the first 3 months and 6 needed a chan ge. However mean alanine aminotransferase levels significantly decreased du ring treatment and were significantly lower than baseline at the end of fol low-up. One patient out of 9 (11%) achieved a biochemical and virological s ustained 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. How ever further studies are needed before expressing any conclusion on this po tentially important option.