Due to the limited efficacy of
alpha-interferon for
chronic hepatitis C amantadine has been proposed as a possible alternative method of treatment. However, few studies about efficacy of
amantadine in
chronic hepatitis C are available with controversial results. Stimulated by recent data in the literature, we studied the effect of 100 mg of
amantadine HCL (alone) PO bid, for a four month period on
alanine aminotransferase serum levels and viral load in a cohort of 18 patients (14 males and 4 females) with
chronic hepatitis C, non-responders to
alpha-interferon. Inclusion criteria were: detectable serum HCV-
RNA,
alanine aminotransferase above the upper limit of normal, chronic
inflammation on liver biopsy, no other associated chronic
liver disease and written informed consent. Available biopsies showed initially four cases of
cirrhosis, six of
chronic persistent hepatitis and eight of
chronic active hepatitis. The most prevalent HCV genotypes were 3a (n = 9, 52.94%) and 1b (n = 6, 32.29%). Viral load (Amplicor HCV Monitor, Roche, USA) and
alanine aminotransferase levels were obtained at baseline and after four months of treatment. All patients enrolled into the study but one completed the treatment. One patient discontinued
amantadine due to severe depression. No significant reduction was observed between baseline and final values of
alanine aminotransferase (139.118 +/- 79.789 vs. 99.588 +/- 62.583 U/L, P = 0.059) and viral load (7.154 +/- 1.596 vs. 6.574 +/- 1.584 log copies/mL, P = 0.147).
Amantadine alone was not effective neither eradicating
viremia nor normalizing
alanine aminotransferase levels in
chronic hepatitis C non-responders to
alpha-interferon patients. It is suggested that only a study with
amantadine alone in-patients without previous treatments could determine its efficacy in comparison with
alpha-interferon.