Efficacy of triple therapy with interferon alpha-2b, ribavirin and amantadine in the treatment of naive patients with chronic hepatitis C

BACKGROUND: There is controversy about the efficacy of amantadine in the treatment of chronic hepatitis C. In this study, we evaluated the efficacy of triple therapy with interferon-alpha, ribavirin and amantadine in the treatment of naive patients with chronic hepatitis C. METHODS: Forty-eight patients with genotype 3 chronic hepatitis C received a three- drug regimen: interferon alpha-2b, 3 million units, three times a week, ribavirin 1000-1200 mg based on body weight, daily, in divided doses, and amantadine 100 mg twice daily, for six months. End of treatment response (ETR), sustained virologic response (SVR), biochemical response and histologic improvement were evaluated. RESULTS: Forty-eight patients, 41 male and 7 female, with a mean age of37.42 ± 16.2 years, were enrolled in the study. During treatment, four patients were excluded from the study due to severe thrombocytopenia, major depression and incompliance. End of treatment response was seen in 38 (86.36%) patients. Among these patients, 34 (77.27%) had sustained virologic response 6 months after the end of treatment and 40 (91%) had improvement in serum level of liver enzyme. Among patients who had response to treatment, liver biopsy was performed for 33 at the end of treatment and 31 patients had histologic improvement. Five non-responsive patients underwent liver biopsy at the end of treatment, and 2 of them had histologic improvement. No major side effects due to amantadine occurred in our patients. CONCLUSIONS: Triple therapy with interferon-alpha-2b, ribavirin and amantadine is a safe and effective regimen in the treatment of chronic hepatitis C.