PEGASYS VS PEGINTRON 2B

I heard pegasys has less side effects and does less damage to the organs then pegintron 2b. My viral load is only 500,000 and doctor isn't even going to start treatment till 2008 so why would he put me on the harsher one. How many are taking the peg 2b. and has anyone tried both or heard the same thing? If it is true I opt for the less harsh one

[PSP-n-Me]

Hi Ralph, I am Beth - Nice to meet you :)

I think it all depends on who the pharma salesperson is that calls your Doctor's office...Most Doctors that treat Hep C, that are not in a big Hospital, have to appoint a Nurse or a PA to deal with those on treatment - here in Ontario the Doctors request a partial payment for that PA from the Pharma's - or in some cases the Pharma's will pay the entire thing, providing the Doctor writes the script for treatment with their product only - In the Clininc I go to they use both, and advise the patient they can choose if they so desire...My Hep Nurse told me that the only "real" difference that she knows of between the two is - Pegasys stores fat in the liver - But, 2 weeks after treatment ends the fat goes away...She also said that her patients have said they felt less side effects from Pegasys (peginterferon alfa-2a) but that is not proven, that I know of anyway...

I use Pegasys becasue that is what my drug plan has on the approved drugs list.

Hope this helps - Beth

[FlGuy]

I've used both and have found that the sides with Pegasys are lesser.  But, like a lot of stuff realted to hcv there are no universal truths.  The meds can affect people differently.  Don't know about the organ damage.

[RALPH44]

Thank you I have not lchecked with my insurance I have crapy blue cross hmo thru the county used to have united they were great but commissioners picked this because they cheep. I have been with my gasto doctor for 7years because I ulcertive colitis so I think if I ask he will change. I heard pegintron 2b is hard on the heart kidneys lungs. I just dont want to get rid of one thing and damage something else cemo did that to my dad

I am so confused

[mikesimon]

I echo FLGuy's sentiments. I have taken both and Pegasys was much easier for me to tolerate. Mike

[RALPH44]

Are you still on treatment? If not which did you say with? I read that for geno 1a pegintron hasa 48% of remition and Pegasys is only 28 %


Shelly

[jmjm530]

How much do you weigh? Peg Intron is weight-based and therefore may give more bang for the buck if you're on the heavy side. Pegasys, on the other hand, is one dose fits all -- meaning more bang for the buck if you're on the lighter side. Both pegs have advocates among some very prominent doctors. If your weight is not an issue, I'd go with the Peg your medical team has the most experienced with. Also, if you're waiting for 2008 to start treating, keep an eye on the Telaprevir trial results by end of this year. If all goes as hoped, they study may produce double the SVR (cure) rates for genotype 1's in half the time. If so, and depending on the amount of liver damage you have, it may give pause to treat now with the current drugs as opposed to waiting for either a Telaprevir trial or when the drug hits the market hopefully in  a few years.

-- Jim

[FlGuy]

I'm on my second round, using Pegasys 2a this time.  But the reason for my relapse was not due to the interferon used the first time (PegIntron 2B).  Reason for relapse was more due to length of tx (24-too short) and amount of riba (fixed dose 800 - too little) given amount of liver involvement (too much).  At least that's what the docs think and I optimistically like to believe.  Few more weeks and we'll see if they are as smart as they think are and as smart as I hope they are.

[moahunter]

I have used both, although on Pegasys I was only on monotherapy. Even so, my experience matches that of others, which is that the side effects are much milder on Pegasys than PegIntron, especially at first.

Pegintron also has an annoying pen application system that, when it works well is good, but is often defective on mixing (I have changed to vial PegIntron due to getting fed up with the pen failing, it requires manual mixing, which is fine with me).

In saying that, PegIntron is working for me, so I am more than happy about it. I was undetectable at 4 weeks and am 24 weeks in now with an ALT of only 22. 24 weeks to go. Side effects are knocking me out energy wise, but I'd rather have a bum year and get rid of this 1A for good.

[RALPH44]

I thought  I posted my weight guess it  didnt show up I weigh about 128. Just had these base line done on my eyes saterday. I started getting this pain in my right side I havent had this since I had my gallbladder out 2 months ago I know it is my liver doctor said I might have that and gosh do my joints hurt I already have 4 buldging disc in my neck I just felt like cramp. What can you do about the side pain? are you all still able to work because I still have to be able to work every day I carry my insurance thru work?

Shelly

[Jesser]

I have been on both before and Pegasys was way easier on me than PegIntron.
It is your liver biopsy stage& grade that would hold treatment off until 2008 not
your viral load...what is your stage? and if your liver hurts that's probably
inflammation that would be your grade.  My physician told me (after I told him
"how much I liked the Pegasys better and thought it killed the virus better")
that he started with PegIntron because it clears from the system faster in
case of an emergency ex.like bleeding from low platelets. Dr. Bencil's website
Hepititis (hepatitis) Doctor gives you a great comparison of the two. My own personal
experience was I'd take Pegasys anyday. Anti-inflammatory always check
with your doctor first.  I was able to work on Pegasys not PegIntron.
Jesser

[RALPH44]

Talked to my doctor today told him I would rather take the Pegasys because it has less side effects he said there are no studies about that told him I had asked real people who had tried both and they said so he said he is more familier with Peg intron and has a real good success rate and he does not know much about pegasys guess I am stuck

:( Shelly

[FlGuy]

Keep in mind that the pegs can effect people differently and many people use PegIntron without large issue.  In my prior comment, I pointed out that the sides for Pegasys seemed to be less than PegIntron.  That's not to say that PegIntron was not tolerable. It was tolerable for me, but not a lot of fun.  To the side a little bit, I have found that the confidence that you have in your doc (and other tx caregivers) is a very important aspect.  So, if you like the doc, have faith in him and trust that you will do well with him then throwing you lot with him might be a reasonable thing to do. Good luck.  as for being 'stuck', count on it - and you'll be doing the sticking with a half inch needle.

[sosad]

I have used both the sides were equally awful.  When I first treated 24 weeks I had heard the same that pegasys was easier. M y doctor wanted to treat with peg intron I  talked him into letting me use pegasys.  I relapsed within 12 week post tx.  I have just finished 48 wks of pegintron und from day13 through tx going for 12 wk pcr at the end of the month hope this time it will stay clear.

[mikesimon]

What is there to know or be familiar with vis a vis Pegasys or Peg-Intron? You inject the stuff at the prescribed dose and you see how it works. I cannot believe some of the stuff I hear that doctors say. The weight based differences that Jim always alludes to are unsubstantiated as far as I know. I would like to see a study on that issue Jim because I have not seen one. Really, when it gets right down to it all the talk about this hepatologist and that hepatologist might make someone feel better but if you can get a doctor who will give you a script for the treatment drugs and scripts for frequent PCR testing and Procrit and/or Neupogen if you need it what more is there to it? It's not rocket science. I took a test at Medscape on treatment of HCV after liver transplant without even reading the course material and got CME credits and I would bet a lot of people here who haven't been transplanted would have passed that test and received CME credits.  Most of the members here could oversee treatment and the outcome numbers would be the same and probably better than the average MD prescribing these drugs.  Mike

[FlGuy]

In reading your comments, I assume you were a relapsed geno 2 or 3? If that's the case, other than change of pegs and going from 24 to 48 weeks, did you do anything else different the second time?  Like change riba dose, other tx modifications?  I'm heading into week 43 of Part 2 and getting near the scary end.  Did you or your doc think the amount of liver damage (I'm early cirrhosis) was a contributing factor to relapse?

[beamishboy]

just wanted to send ya some goodluck my friend..hope all  works GREAT for you...Doing 48 as oposed to 24 weeks has got to kick them bugs butts..justa long row to hoe..FAREWELL

[rochammer]

Pegasus or Peg-Intron I did both Pegasus for 24 weeks & peg-Intron for 48. Pegasus was easier but I relapsed. I am also a geno 2. The thing I would look at more is the short course of tx for peg-intron vs Pegasus. 12 weeks for peg-intron and 16 for Pegasus. If for some reason you cannot complete the 24 weeks you may have a better shot with Peg-intron. Stuck with your doc if you like him.

It’s time for my one year PCR will see if I am still SVR.

Good luck

[jmjm530]

Mike: cannot believe some of the stuff I hear that doctors say. The weight based differences that Jim always alludes to are unsubstantiated as far as I know. I would like to see a study on that issue Jim because I have not seen one. Really, when it gets right down to it all the talk about this hepatologist and that hepatologist might make someone feel better but if you can get a doctor who will give you a script for the treatment drugs and scripts for frequent PCR testing and Procrit and/or Neupogen if you need it what more is there to it?
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Tell you what, Mike. I'll stop talking about what my hepatologist says as soon as you stop quoting yours :)

But seriously, Peg Intron is one dose for all weights and Pegasys is weight-based. No one disputes that.

And there are also some studies that suggest that more Pegasys (double-dosing) produces better results. (See Clinical Options Site.)

I therefore think it's reasonable to speculate that if you're on the light side, you will get more bang for the buck from Pegasys and if you're on the heavy side, you might get more bang for the buck out of Peg Intron -- assuming that you are dosed based on SOC in each case which is how 99.9% of folks are dosed.

Where did I first hear this? From my hepatologist of course, who btw is in the same league as I assume yours is. I then heard it from others as well who heard it from their own doctors.

Are there studies on this? Of course not and you know that. Truth is that the vast majority of studies on the efficacy of these drugs are done/supported by Roache or Schearing and not surprisingly the results of their respective studies supports their own drug.

But again, there are enough studies to suggest that higher doses (Peg and/or riba) produce better results, assuming the patient can and will tolerate the higher doses. In fact, I believe it was Dr. A. from Boston, who made this very statement in a Q&A at a conference that someone recently posted here.

-- Jim

[FrontRangeMom]

Ralph I've used both.  Can't really compare because Pegasys was with Riba, PEG-Intron was without.  I think if you read the package inserts for both you'll find that the safety profiles and adverse events are about the same.  You can get the PI's from the drug company's websites. Some may have the same or different experiences and there is probably no way to predict in advance how you'll react to either.
"Mom"

[zazza]

That talk about weight based dosing, I don't get that either. Pegasys is one dose for all 180 mcg. PegIntron is weight based, maximum dose 150 mcg. So for a lighter person to get Pegasys would be a benefit, but for a heavier person to get PegIntron would still mean he would only get at the most 150 mcg compared to 180 mcg Pegasys.

[jmjm530]

Zazza: PegIntron is weight based, maximum dose 150 mcg. So for a lighter person to get Pegasys would be a benefit
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That was my point. Pegasys would benefit a lighter person and that was the point my hepatologist made to me when I was trying to decide, although at 175 lbs, I was pretty much borderline.

Zazza: but for a heavier person to get PegIntron would still mean he would only get at the most 150 mcg compared to 180 mcg Pegasys.

I don't believe you can compare mcg's of Peg Intron to Pegasys. Different molecules. But the fact that Peg Intron is weight-based seems to suggest that the manufacturer feels that a higher dose of that drug is needed for heavier people.

[mikesimon]

I have quoted my transplant surgeon and I know you don't have one of those but never my hepatologist. I wasn't referring even obliquely to you when I said that about hepatologists - I wasn't even thinking about you. I don't really know who treated you but now that I think about it I would guess Dr. Deitrich but I wouldn't bet money on it. My point was that it doesn't take a world renown hepatologist to oversee treatment.
Mike

[CockSparrow]

Jim - Are there studies on this? Of course not and you know that.
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There kinda is. All the short course Pegasys studies prodiced higher SVR rates if you weighed less than 75 kgs (165 lbs). There was a Taiwanese G2 study that used WBR and Pegasys for 16 weeks that produced way higher SVR rates than Accelerate. Their assessment of the difference between the two studies was "In the ACCELERATE Trial, the mean body weight of patients with HCV2 was around 84 kg (165lbs), with a mean ribavirin dose of 9.52 mg/kg/day for a daily dose of 800 mg, in contrast to 15.3 mg/kg/day in our study. The difference may explain the conflict in the results between the ACCELERATE Trial and this study."

Using the Manns study for PegIntron stated that the weight based Tx evened out the SVR rates.

Jim - Truth is that the vast majority of studies on the efficacy of these drugs are done/supported by Roache or Schearing and not surprisingly the results of their respective studies supports their own drug.
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This is so true. Some meaniful comparisons wouldnt go astray.
Neither is necessarily better but they are different.

When all said and done though some people respond better with Pegasys others with PegIntron.
CS

[jmjm530]

Thanks for the input. BTW I wasn't pushing either Peg -- for fat or thin people even -- just relating some impressions I've received. After speaking to at least a half-dozen top hepatologists over the years on Peg Intron Vs Pegasys, the one thing I found in common that all had a bias one way or the other, although on further questioning they would admit that the study data was mixed. To me, different doses of Peg for different people make sense under the umbrella of individualized dosing. We're already seeing this with double-dosing or once-every-five-day dosing studies.

-- Jim

[zazza]

I still don't get it. As I see it, a comparable fixed dose of PegIntron, not weight based, would be 150 mcg. This would then benefit the lighter persons, who are today getting 80, 100 or 120 mcg. I can't understand how any one can be benefited with less than max dose. That is what PegIntron offers: less than max dose for lighter people. Pegasys offers max dose for everyone. Is this not so?

[zazza]

That's what my nurse told me when I started treatment, that lighter people benefited from Pegasys, not that heavier people benefited from PegIntron.

[zazza]

A heavy set geno 3 on fixed dose PegIntron will get 100 mcg, but on weight based dose he would have gotten 150 mcg. On Pegasys he would always get 180 mcg. This is the fixed dose my ex got: 100 mcg PegIntron, 800 mg Rebetol, 24 weeks. Now he will get 180 mcg Pegasys, 1200 mg Copegus, 48 weeks.

[FlGuy]

'A heavy set geno 3 on fixed dose PegIntron '... I've never seen fixed dose for PegIntron,  Even for mono-therapy it's expressed as weight-based.   Being a relapsed g3 myself,  docs guessed it was more due to the fixed dose riba (800) and not so much the weight-based PegIntron, as long I was weight-based appropriately (I was) for the peg Intron.  Like Mr. Ex-za I'm doing 1200 and 48 this time.

[mikesimon]

I blame inadequate ribavirin dose on my relapse as well and I blame that for my late clearance my second treatment. I really don't think there is much difference, if any, in the effectiveness of the 2 pegs - it's the sides that I found markedly different. Mike

[jmjm530]

Zazza: when I started treatment, that lighter people benefited from Pegasys, not that heavier people benefited from PegIntron.
---------------------------------------
I think that works out to the same thing and maybe you might ask your nurse. l still don't think you can compare "mcg's" of one peg versus another since they are different molecules and therefore may not  act exactly the same. Of course, there's no rule that says you have to take 180 mcg/wk of Peg or follow the weight-based dosing of Peg Intron, but we're talking SOC. Beyond SOC, the trend seems to be to up the Peg dosing in re-treatment scenarios and hard-to-treat populations. On a personal note, I initially double-dosed Peg my first (and only) time on treatment and was told I might expect a 10% better chance of SVR.

-- Jim

[zazza]

Interesting, and I actually can't find any information on lower dose of interferon for geno 3's in the product information for PegIntron. Surely this can't be something they do just here in Sweden? Maybe they give geno 3:s 1 mcg/kg instead of 1.5 mcg? FlGuy, we are following your case closely, hoping you will give us hope by attaining SVR! Zazza

[FlGuy]

it appears that it's 1.5mcg per kg, regardless of geno.  see www.pegintron.com and then 'prescribing info'  (that's probably what you are looking at already).

And, me too!

[zazza]

A fixed dose on the high end does not benefit those who would have received that dose even if it was weight based. But I will give you the benefit of the doubt, and ask my nurse next time. By the way, I passed my weight control this week by drinking a h**ll of a lot of water and thereby passing into the next weight class for PegIntron! I did my first shot with 120 mcg today. Zazza

[jmjm530]

.Congratulations on making it to the "heavyweights". LOL. I used to wear my heaviest boots and load my pockets with coins and stuff at the weigh-in's. In my case, not because of the Peg (I was on Pegasys) but because of the ribavirin.

-- Jim

[FlGuy]

I guess you are using RediPen. If you crossed the threshold to the '120' Pen, which mean you leaped across 61 kg?.  If so, the 120 mcg pen is used for weights 61-75 and 75-85 depending on if you turn the dial to 4 or 5.  If you are in the low end (around 61 kg) you can turn the dial to '5' and get the weight based dosage for someone as high as 85 kg.  Confusing, I know.

[RALPH44]

You all are great. You tickel me. I am dont feel alone any more :)  my weight is 128 and I am 5' 2 I would prefer to take what is base on my size rather than one size fits all.  lf that makes sense. My husband is happy because he says Peg intron has a 48% remition were as Pags 28%. My older sister when she found out I had hep C 1a she automaticly had me dead and burried. My viral load 500,000. very little liver damage doc 0.

[FlGuy]

You wrote that you have very little liver damage - 0. Was that assessment form the results of a biopsy?  If it was a biopsy, you may have the luxury of time on your side.  With '0' damage you could consider waiting for newer drugs that will probably come available in the few years ahead.  If you did not have a biopsy, do you know on what the '0' liver damage was based?  And, that  48% vs. 28% svr rate of PegIntron vs. Pegasys doesn't sound right.

[mikesimon]

I want to wish you good luck with your treatment. Mike

[CockSparrow]

Jim - I wasn’t saying that you were pushing either Peg. Just that the studies support what you are saying in a roundabout way. Pegasys studies tend to state that SVR is higher when weighing less than 75 kgs and the PegIntron ones tend to say that weight basing tend to even SVR out to an extent.
BTW WBR seems to be more important with PegIntron than with Pegasys. The PegIntron short course studies produced better results than most of the Pegasys studies. Mangia only used 1mg/kg PegIntron and still got excellent results. The Pegasys ones tended to have lower relapse rates for G3s at least.
The Taiwanese Pegasys G2 study also produced excellent results but it used WBR with higher RBV levels than normal. 15.3 mg/kg/day is quite high, which would seem to indicat that pegasys could also benefit from WBR even if the Hadziyannis study thought otherwise.

FYI - G2/3 SOC of 24 Weeks and 800mg RBV was based solely on the Hadziyannis study. There were only 96 patients in the 24 week LD RBV arm. At the time there had been no 24 week PegIntron Studies. Zeuzems was the first and it used a mathematical model based on the Manns study to calculate 48 weeks SVR.

The Manns/Zeuzem and Hadziyannis studies are also an interesting read when comparing results as different factors influenced SVR. For Example Hadziyannis had a 13% relapse rate for G3 HVL Zeuzem had 23%.

For me they both have there place and I would hate to see the marketing campaign of one win the sales war.

Jim - To me, different doses of Peg for different people make sense under the umbrella of individualized dosing
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I totally agree and is one of the reasons why some meaningfull comparisons wouldnt go astray.
CS

[jmjm530]

That was a general comment and not addressed to you at all. Thanks again for your input and study data. We are definitely on the same page.

-- Jim

[mikesimon]

I have spent an inordinate amount of time researching the relative effectiveness of Pegasys and Peg-Intron and I want to admit that I think you are correct. Peg-Intron has been shown to be a better approach for obese patients. I agree with you 100%. Mike

[jmjm530]

Thanks Mike for the additional research and comment. As we both appear to agree, one Peg hasn't been proven any better than the other, and probably won't be given the way these studies are structured and given the people who sponsor them, i.e. the drug companies.

That said, the drugs are dosed differently, and a number of studies suggest that dosing may have more importance than probably originally thought when these drugs first came on market. Of course this raises the question, why wouldn't a doctor simply prescribe more Pegasys (beyond the 180) for the obsese patient -- and no doubt some may be -- but that takes us beyond the world of SOC.

All the best,

-- Jim

[drofi]

The idea behind weightbased and fixed dosis is the different distribution in the body. The larger Pegasys (40KD) is distributed in the blood and liver only and the amount of blood and the size of the liver ist not proportional to the bodyweight. You have about the same volume of blood and the same size of the liver, if you are fat or not.
PegIntron is smaller and has another distribution, e.g. into other tissues.
In addition both have a different halflife.
Therefor it could be true, that PegIntron works better to controll the virus in distant reservoirs, but Pegasys works better because of a flat kinetic profile during the week, without a gap at the weekend. The result would be the same efficacy and rate of SVR, but for different reasons.
I would like to see a study with a combination of both Pegs.

Regards, drofi

[jmjm530]

How do you then account for better SVR results in the  Pegasys double-dosing studies, or the shorter-course studies CockSparrow mentioned earlier in the thread where SVR rates increased if you weighed less than 75 kgs (165 lbs)? I suppose you could argue it might have been the riba, but more and more seems to point that the more drugs (peg and/or riba), the better the SVR rates. The question then is how much is too much in terms of both QOL and what the drugs do to the rest of the body.

I agree that combining both Pegs would be interesting approach to explore. There are many ways this could be accomplished, from taking both Pegs at the same time -- to starting with one Peg and then switching to another -- to alternating Pegs on a weekly basis.

[drofi]

I think the question of comparing higher doses with lower doses is independent from the other points. Just as you said, the question is how your body tolerates higher doses. My own body accepts higher Ribavirin well, but having 20.000 platelets after starting therapy I decided not to add additional IFN to the180 ug Pegasys, but did not reduce the dosis, although this is a risk.
There are so many studies that should be done. I would like to see a study with Telaprevir as an add-on, not at the start of the therapy. Resistance is the drawback of VX-950, why don't they start to lower the viral load with SOC for 4-8 and add Telaprevir than? The statistical chance to get mutations is lower when the number is lower.

[jmjm530]

Interesting, or what about the reverse. Do 12 days (instead of ten weeks) of Telaprevir to knock the virus down and then follow-up with 24 weeks of SOC to kill off any resistent strains, assuming an RVR. The shorter TElaprevir course should circumvent the Vertex rash that many have gotten.

[drofi]

yes, I hope all these studies will be done soon after marketing authorisation as investigator initiated trials.

[beamishboy]

my docs-syracuse univ -are doing a trial comparing the two.....

[sosad]

sorry it took so long to respond I was away for a few days  I was a genotype 2b and relapsed after the first 24 weeks of treatment I was und throughout the 24 weeks but they did not do pcr until 12 weeks so I do not know if I was an early responder.  When I retreated I did have and increase in the riba dose from 800 to 1000. No other modifications to tx.  I do have early cirrhosos and both the doctor and I feel that might have contributed to relapse.  While on the second round of tx I had many more parts of my body affected by the meds hopefully my liver has had some rest from the virus and my und will continue post tx.

[gauf]

I share your tox history to a T. 2b relapser. Increased riba from 800 to 1000, and went from pegasys to pegintron for 24 weeks. I too was und after 12 wks and throughout. Relapse at 6 mos post. Going back to pegasys and riba to 1400/1600 for 48 weeks.  I am 240 pounds. I am going with pegasys though because I relapsed the first round on it but VL just 250,000 at 6 mos. The pegintron at 24 week treatment had a VL of 4 mil at 6 mos. So, feel the pegasys worked better.

[FlGuy]

We share similar profiles. I'm geno 3.  Here's to the second time around and triumph of hope over experience!

[gauf]

This will actually be my third time around. I wish us all good luck.

[niceguy2007]

i used pegasys 180mcg for 24 weeks.

i weight roughly 60kg and therefore received a high dose of pegasys.  

doctors have not been able to explain my reaction to the drug.  my first 2 shots of pegasys caused intense burning in my entire body exactly 20 minutes after the shot.  this lasted for about 40 minutes each time.  

it also caused throat constriction, difficulty breathing and minor hives.  

but the most telling symptom was the burning feeling that i felt deep in the gut, as well as in my limbs, face, and tongue.  my vision was also affected and the field of vision actually trembled, which was really scary.

[umerises]

I need some informaiton. I am 27 years Old.  I felt symptoms of aching, sever headaches, eye aches, Backaches, joint aches, some times liver ache, general body aching. looks eyes are burning. Feel severe weakness and tired all the day. Want to sleep more. some times chest ache on my right side. If mistakenly my finger pushes strognly on table or some thing hard matter. i feel more pain than ever.  My doctor told me I got hepatitis C virus. I can not concentrate my studies and my Lab work very well. I feel some times temperamental mode Off. My SGPT, and ALT, all liver enzymes reported in the Normal Range. Doctor has also done my Viral Load test. For what I am waiting?. Can any body tell me, " When my liver enzymes are normal, then Why I am feeling these pains and symptoms????

[niceguy2007]

umerises, are you from Pakistan?  from what i gather, your symptoms sound surprisingly similar to mine before treatment.  I had genotype hepatitis C genotype 3a virus, which you probably have too if you are from Pakistan.

[beth82463]

my husband had a liver transplant sept 10 2007 he was never treated before for hep c . 3 weeks after transplant hep c came back at a viral load of 10 mill. treating with pegintron and ribo. at 10 weeks  he is still in the 6mill  has had to get many units of blood  as well as nupagen shots white blood count down to .9 . his dr told him he has only seen a couple of people with hep c that is so aggressive.  any one else in the same boat or know of anyone ? they say that the pegintron is the best for him and that if that isn't working the pegasus won't work either.   beth.
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