Lowering your dose of interferon will bring them up. Taking neupogen should bring them up. And exercising vigorously just prior to getting your blood sampled should make the neutrophil lab reading somewhat higher (but wont actually raise your neutrophils).
There's no way to know how likely or unlikely any particular person would be to clear by whatever week, especially on reduced IFN dose. The only thing that can be said with certainty is that cutting the IFN dose in half for an extended period of time like that, especially early on in treatment prior to becoming UND, will lower the odds of treatment success. However, there's no doubt some people would be more likely to get away with this than others. For instance, a patient who has "positive treatment criteria" working in their favor would be more likely to successfully tolerate an IFN dose reduction than another patient who has factors working against them. For instance, lets define two patients as an example:
Patient 1: Genotype 2, F1 fibrosis, starting VL of 500,000 IU/ml (i.e. low), 21 years old, thin (low BMI), and otherwise healthy
Patient 2: Genotype 1, cirrhosis, starting VL of 6,000,000 IU/ml (i.e. high), 44 years old, 20 lbs overweight with high blood pressure.
Patient 1 is younger, thinner, has less liver damage, a low starting VL and above all has geno 2 which is much more responsive to IFN and riba treatment than geno 1. This person would clearly be much more likely to become UND and to become UND faster than patient 2, and would be much more likely to get away with a 4 week IFN dose reduction than patient 2. So really, it's also an individualized thing based on personal criteria. All you can do is get a feel for the trending of the driving variables and take a guess. Although frequent VL testing can give you a good idea where you stand, especially during and after the critical interval of dose reduction.
Personally I would not do anything/take anything without your specialists advice. I was told that trying to boost your immunity by non-specialist prescribed means while on tx is not a good idea. Cant say that I really understand why, but the person that told me seems to know what they are talking about.
My Neutriphils dropped to 500 and i took a shot of nueprogen last week they are up this week and i do another shot today. I would not take the chance of lowering my interferon, although i don't know what your health history is. Nueprogen is a rescue drug used by many people on tx. I'm not thrilled about taking it, but so far it is working and it keeps me able to stay on tx. I wish you the best.
I don't know a thing about hemophilia (other than the obvious), but is there any reason why Nick's doctors can't give him Procrit and Neupogen to boost his HGB and ANC's? I'm assuming that you're aware these two drugs can be used in "ordinary" HCV patients to boost HGB and ANC levels in order to prevent IFN and riba reductions? (thereby increasing odds of treatment success) We see a lot of patients on this forum who experience ribavirin and/or IFN dose reductions that could otherwise be avoidable simply because their doctors are unaware that rescue drugs can be used in this fashion. Or simply because their doctors are inexperienced with these drugs and therefore shy away from their use due to a lack of familiarity. Of course like I said, for all I know hemophilia may change everything in this respect, but I wouldn't simply assume this without looking into it further. I'd doublecheck on this by researching this situation online and then following up with pointed questions to his medical team to see if using these drugs might be feasible for the purposes of getting his IFN and riba doses back up to full strength.
Wishing you and your son the best, sorry you have to go through all this. Must be tuff!
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