Amantadine in treatment of chronic hepatitis C virus infection?

Abstract

Treatment of chronic hepatitis C (CHC) continues to be an important and growing challenge. As the response rate to FDA-approved treatment improved over the past decade, we are facing increasing number of difficult-to-treat patients such as those who have failed prior anti-viral therapy. The role of amantadine in the treatment of CHC remains unclear. Studies thus far have produced conflicting results, and type II error could not be excluded. This review summarized results published in the literature from 1997 to 2003, and reviewed the existing questions and controversies regarding the use of amantadine. Current literature suggests that amantadine is ineffective as monotherapy. Amantadine increased the sustained virologic response of certain treatment naïve patients when used in combination with interferon, and may be effective as an adjunct to interferon-based combination therapy in some patients who have failed or relapsed on prior therapy. Factors such as small sample size, patient characteristics, and differences in treatment protocols including amantadine preparation and duration of therapy might explain the conflicting observations of various studies. Further investigations are needed to define optimal dosing and formulation of amantadine, and its appropriate role in management of CHC infection.

Chapter 2 Viral Channel-Forming Proteins

“…New derivatives of these drugs are being developed in the hope of overcoming drug resistance (Kolocouris et al, 1996). Amantadine is also under investigation for treatment of chronic hepatitis C virus infection (Lim et al, 2005) and seems to affect p7 when this protein is used within a GST-His-p7 or GST-p7 construct (Griffin et al, 2003(Griffin et al, , 2004. In a recent study with full-length p7, amantadine shows no affect on the channel activity of p7 in a range of up to 10 mg/ml (Steinmann et al, 2007b).…”

Amantadine triple therapy for non-responder hepatitis C patients. Clues for controversies (ANRS HC 03 BITRI)

“…In conclusion, it is undisputable that a trend for a beneficial effect of amantadine exists, especially in nonresponder patients [32]. This trend has been confirmed in a meta-analysis based on pooled data [15].…”