Hepsera( Adefovir)

Hi sir
  One of the patients had been referred to my center. His disease presented from More than 4 years. Initial laboratory examinations showed elevated ALT and AST and HBsAg and HBeAg. The patient had no history of drug consumption and blood transfusion. He treated with Lamivudine for two years and after that with alpha interferon for 4 months in other center.when he came to our center, his ALT and AST were elevated and Quantititation of HBV with Roche Cobas Amplicor showed the titer is more than 30,000,000 copy/ ml. I started the Adefovir for him from 11 month ago and after 3 months the titer decreased to 1,500,000 copy/ ml and the level of ALT improved.But after 8 months the titer increased to 5,000,000 copy/ml and his ALT=69 and AST=135 elevated.I like to continue the drug to more than one or two years.
Please do not hesitate to contact me, if there is any query.
    

With high esteems and best regards.

[cuteus]

I am not positive as to whom you are trying to contact, but I just wanted to advise you that this is a hepatitis forum, visited by patients or relatives of patients and there are no medical doctors monitoring and answering questions at any given time.

[LvdByGod]

sorry to briefly interupt but, i posted a message below on my thread about side effects...pain...etc...in responce to those that answered...i was wondering if you all could read it...there is one more favor i must ask from you guys before i head out to the dr...in 30 minutes...it's 3:22 ct here now...thanks all...

[couchpotato]

Sorry to break into this thread, thought I'd pass along what I heard from my Canadian "specialist" yesterday. First of all, I just did my 7th shot on Friday and when I walked into his office he asked me if I was ready to start tx!!!!!!!!!! Holy ****!!! I just about fell out of my chair, doesn't exactly make you feel all warm and fuzzy about the quality of care you are receiving!! Also had this juicy tid-bit of info he never felt compelled to tell me earlier. In Canada, the way our health care system runs (it is for EVERYBODY at a nominal cost), if you have no other insurance/coverage the province will provide ONE free course of treatment. Good right? Here's the kicker. IF you need Procrit or Neupogen they will take you OFF treatment rather than provide the drugs, as they are WAY to costly!!!!! Politics??? You bet your ass. I was/ am shocked and now getting concerned about the months to come, is it all going to be for nothing?? Things are starting to slide, I'm still okay for now, I think, but for how long? Here are my latest numbers, anybody know how low I can go before I start freaking??
   WBC  4.4   RBC  2.96    Hemoglobin  96  Hematocrit  0.28
Good new is my ALT is 40  Platelets are 158  RDW  15.0
  Thanks for any insight.  Couch

[TnHepGuy_]

Thank you very much for the kind words.

I have enjoyed your company here very much, also.

It's good to hear that you are feeling better now - we certainly have to make the most of those type days.

I was thinking of you a short while ago - when I was out in my vegetable garden - weeding, fertilizing and picking some broccoli, radishes, lettuce, spinach - and eyeing up the peas, which should be ready for picking in a few days. I was wondering how your garden has been coming along so far?


TnHepGuy

[cuteus]

well. I just counted 4 boxes of 4 vials of Procrit in my fridge, that I was wondering when I was going to use....soooo.... honestly, I am probably not going to need that much. But I would have to declare it if I was going to mail it accross, just an idea...
your blood work is measured in different units than mine so I have no idea how to convert it.    
I know ringading just finished her 24 wks and not only did she have to ride her low counts, they did not do a 12 or 24 wk vl.  they will do a 6 month post tx only. I believe she was a geno 2.  they make it tough to tx  in Canada, it seems.  GL with everything

[cuteus]

ringading is vacationing in Costa Rica after finishing her ardous journey thru TX,,,,envy

[couchpotato]

Do you know off hand at what point I should start to worry about my WBC and RBC? I am hoping I will not go much lower and stabilize. My hemo is kinda low but not anything to concern myself over. You have an incredible amount of knowledge about we all go through, my hat goes off to you, sometimes I have the hardest time remembering even the smallest thing. Duhhh!

[couchpotato]

Hey thanks, that's a great offer but we are probably jumping the gun. I will sure keep that in mind though, if I should have to go that route. Yeah, I am genotype 2 and had no viral count and there will be no PCR at 12 weeks. He will check (if he remembers...hahaha) when I am done and again at 6 months. I guess besides Ringading (and she has disappeared), there are no other Canadians on this board. Hmmm, I wonder where they are getting their support or if Ringading, my husband and I are the only ones infected in the Great White North????????? LOL!! Anyway, thanks to everyone for always helping and advising this Canuck through this somewhat puzzling and arduous journey.  Couch

[twotells]

I'm glad I said something to give you courage- especially to a person who gives so much to everybody around here.  I wish you well with Dr. 'Brown Eyes.'  Dave

[catherine194]

I don't quite understand your post. I take it English is your second language. My brain gets ahead of my fingers or I just forget what I was going to type but if you are reccomending your clinic sounds as if your getting good care. I hope so. If you have a question can you rephrase it? I will try to answer or I know someone here will. I am here for you regardless and a lot of people have trouble understanding me with my heavy southern accent. Thank God for Texas!

[TnHepGuy_]

Scott's right on the mark as far as neutropenia (i.e. - low neutrophil/ANC count goes). The thought up until recently has been to intervene with Neupogen when neutrophils were at the 750 level. Now, more and more docs are allowing it to float down to the 500 level without concern.

The initial studies on low neutrophils were done mostly on chemotherapy patients - whose immune systems are very seriously compromised as a result of the chemo - thus leaving them vulnerable to infection. Hep C patient's immune systems aren't nearly as compromised by the interferon - and infection is considered less of a concern.

This <a href="http://www.hcvadvocate.org/hepatitis/About_Hepatitis_pdf/1.1_Hepatits_C/Neutropenia.pdf">study</a> is a good reference on the subject.


TnHepGuy