low platelet

[cam76]

hi i need to know. i went to dr. and i cant do treatment because my low platelet is 60 how can i raise them so i can start treatment. i have hep c

[Kathy73]

Not necessarily! I am stage 2 and I had low platelets so I do not have that extensive damage you mentioned. This person may have ITP or another reason his platelets are low.

CAM: have you had a biopsy?

[HectorSF]

I would suggest proceeding with caution no matter what you do and highly recommend finding a very experienced Hepatologist to consult with before making any life changing decisions.

Since you have a platelet count of 60k (norm being 150k-450k) this would indicate that HCV has caused rather extensive liver damage (compensated cirrhosis). You probably also have other signs that your liver is unable to function fully, including an enlarged spleen, varicies, and possibly other physical signs of your liver disease.

As far as eltrombopag/Promacta...again I would exercise caution and get a doctor's opinion first.

Important Safety Information
BOXED WARNING
PROMACTA may cause hepatotoxicity.  Patients receiving therapy with PROMACTA must have regular monitoring of serum liver tests. Discontinue PROMACTA if ALT levels increase to ³3X upper limit of normal (ULN) and are: progressive; or persistent for ≥4 weeks, or; accompanied by increased direct bilirubin; or accompanied by clinical symptoms of liver injury or evidence for hepatic decompensation".

Regarding interferon. A known side effect of interferon is the lowering of platelet counts. As your platelet counts drop you will be asked to reduce your dosage of interferon. This will reduce your odds of clearing the virus. (Having cirrhosis, already reduces your changes of SVR by 10-15%)  Then if your platelet count continues to get lower, (20k?) depending on your doctor, treatment will be stopped.

It is also important to realize that treatment has a small (about 3-10%) but real risk because of your advanced cirrhosis, of causing your liver to decompensate. This is no small matter, because if that should happen, your only option would be a liver transplant.

In summary, I think it is important for you to discuss the benefits vs risks with an experienced Hepatologist who can help understand All of the factors that you need to consider before making such a life changing decision.

Best of luck to you whatever you decide to do.
Cheers!
Hectorsf

[Kathy73]

I have ITP and HCV. My platelets have been in the 40s for over 5 years. I had to have gamma globulin infusions in order to get my platelets up to get the liver biopsy. That works in the short term but is expensive and time consuming (5 day 6 hours per day treatment). Saying that I've been on SOC for over 4 months and my platelets have gone up. I am now 144. I hope that this happens with you, but even if it doesn't (and I think I'm an abberretion (sp)), maybe you could try the SOC and see if you beat the platelet odds. I don't understand why your doctor won't even try. My platelets were only 40 when I started.

[CoWriter]

Strictly for ITP only Bill.  But remember, many HCV patients have ITP.

Co

[FlGuy]

The stuff Bill mentioned is also known as 'Promacta' or 'Revolade' (in Europe).  Many people start treatment with low platelets.  For many, the treatment meds lower them further. However, your current platelet level does not necessarily preclude you from treatment.  If the Doc who is advising you is not a very, very experienced liverhead (Hepatologist) you might want to get a local recommendation for one in your area.  Addressing your situation sooner, rather than later, is probably a good thing to do.

[Bill1954]

Ask your doctor about the availability of the drug “eltrombopag”. I don’t want to raise false hopes, but this drug has just recently (late 2008) been FDA approved for low platelets in ITP; perhaps it’s available off label for HCV.

Good luck—

Bill