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    New Treatment Offers Hope for Hardest-to-Treat Hepatitis C Patients


    "I think this study shows that treatment with several antiviral agents given simultaneously is a good approach," study author Stephano Brillanti, MD, of Italy's University of Bologna, tells WebMD. "The lessons we learned from treating HIV will serve us well in the treatment of hepatitis C. We are learning that the best options in difficult to treat patients is a cocktail approach, like that used to treat AIDS."

    It is estimated that four million people in the United States are chronically infected with hepatitis C, and as many as 70% will develop liver disease caused by the virus. Worldwide, some 170 million people are infected with hepatitis C. Infection can lead to cirrhosis, liver cancer, and liver failure and is the most common reason for liver transplants in the U.S. today.

    Because symptoms do not generally develop until a decade or more after infection, many people who have chronic hepatitis C don't realize it.

    In the study reported by Brillanti and colleagues, 40 patients were treated with the triple-drug therapy containing amantadine, and 20 patients received the interferon and ribavirin combination only. The patients received therapy for one year.

    Almost half of the patients treated with the triple-drug therapy had sustained responses to treatment six months after its completion, compared with just 5% of patients treated with the interferon and ribavirin combo alone. At one year after the end of therapy, almost 40% of the responding patients given the three-drug regimen had not relapsed, Brillanti says.

    The Italian researchers are now testing the three-drug regimen in a group of 500 patients who failed initial therapy with the interferon and ribavirin combination. They published the results of this study in the Sept. issue of the journal, Hepatology.

    "We were very skeptical before we saw how well this worked, but we now believe amantadine may act synergistically with interferon and ribavirin. We aren't exactly sure how, but we think it is very exciting."

    Eugene R. Schiff, MD, of the University of Miami (Fla.) Center for Liver Disease, says he remains skeptical about the usefulness of the three-drug combination therapy, although he quickly adds that he hopes the Italian findings are confirmed. His center is currently using the regimen in some patients, as are others around the U.S., and he says more data will certainly be available within a year. Schiff, a spokesman for the American Association for the Study of Liver Disease, reviewed the study for WebMD.

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