ROLE OF AMANTADINE IN TREATMENT OF CHRONIC HEPATITIS C

Abstract

Background: Interferon afla (IFN-alfa ) is the only effective
treatment for patients with Chronic hepatitis C. Forty percent of patients have an initial response to therapy.
But most subsequently relapse. Amantadine, an antiviral agent, in addition ability, of preferably concentrating
in liver , has shown a role in reducing hepatic inflammation and suppressing viral replication . The aim of this
study was to assess the efficacy and safety Of amantadine for treatment of chronic infection with hepatitis C
virus (HCV). Design: Prospective study. Period: From January 2002 to Dec 2003, Setting: Allied Hospital,
Faisalabad. Methods: Fifty patients either naive or interferon resistant, with age range of 18-65 years. were
enrolled and treated with amantadine 100mg orally twice daily for six month. Control groups included the same
cohort followed of therapy for 12-18 month or during therapy with interferon .All patients were assessed for
safety. Tolerance and efficacy at the end of every month during treatment was completed. Patients were
followed up for an additional six month to assess durability of response. The primary end - point were loss of
detectable HCV-RNA six month after cessation of therapy. Findings: Out of 50 patients treated for six months
with amantadine compared to intervals without therapy or to interferon therapy,17 (34%) had normal serum
alanive aminotransferase (ALT)values and had cleared HCV RNA in serum by the end of treatment . The
sustained virological response was found in 11patients with an undetectable serum HCV RNA level six month
after therapy Baseline low serum HCV RNA levels were associated with higher rates of Response . During
the therapeutic trial, amantadine caused no potential treatment limiting side effects but had a good safety profile.
Interpretation: Therapy with amantadine results in biochemical as well as virological response both in the naive
and interferon resistant cases of chronic hepatitis C.