Riba, Neupogen, impact on Immune System / WBC

[hcvJames]

From a reply by HectorSF to Jenge about 'how these meds work', talking about Ribavirin ...

"It may actually help strengthen your immune system, which is your body's natural defense against infection. With a stronger immune system, your body can be more effective in getting rid of the hepatitis C virus."

First just a nitpick .. Since no alternative explanation of what Riba does, why it's the second pea in this pod of treatment, they could be a little more definitive. "May" help? Seems pretty vague for a highly researched drug and treatment. But presume they really mean "It actually helps .."

Then my question is ...

I have a script for Neupogen. One shot a week, but I'm averaging one every 3 or 4 weeks.. Got the script on 03/27/12 and have taken only 4 shots since. As all know, Neup is used to boost the WBC/ANC count. WBC/ANC is the immune system.

If Riba boosts the immune system and Neupogen boosts the immune system ..
Have I been negatively impacting treatment by not taking Neup shots on time?

Or .. was the explanation of Riba's workings generalized down to fit a short article cuz I thought Riba caused low WBC (in those that have it) which wouldn't fit if it boost the immune system. As you see I get confused easily.

[willbb]

The growth factor(Neup) would have no bearing on the immune system It is only a bone marrow enhancement for production of white cells.Not taking it  would have no effect on tx. other than possibly your ANC would be low...which in itself  when doing HCV tx, has been shown to not have much impact on infection ..

Good luck

Will

[hrsepwrguy]

DESCRIPTION
COPEGUS, ribavirin, is a nucleoside analogue with antiviral activity. The chemical name of ribavirin is 1-β-Dribofuranosyl-1H-1,2,4-triazole-3-carboxamide and has the following structural formula:
The empirical formula of ribavirin is C8H12N4O5 and the molecular weight is 244.2. Ribavirin is a white to offwhite powder. It is freely soluble in water and slightly soluble in anhydrous alcohol.

COPEGUS (ribavirin) is available as a light pink to pink colored, flat, oval-shaped, film-coated tablet for oral administration. Each tablet contains 200 mg of ribavirin and the following inactive ingredients: pregelatinized
starch, microcrystalline cellulose, sodium starch glycolate, cornstarch, and magnesium stearate. The coating of the tablet contains Chromatone-P® or Opadry® Pink (made by using hydroxypropyl methyl cellulose, talc,
titanium dioxide, synthetic yellow iron oxide, and synthetic red iron oxide), ethyl cellulose (ECD-30), and triacetin.

12 CLINICAL PHARMACOLOGY
12.1 Mechanism of Action
Ribavirin is an antiviral drug [see Microbiology (12.4)].

12.4 Microbiology
Mechanism of Action
The mechanism by which ribavirin contributes to its antiviral efficacy in the clinic is not fully understood.
Ribavirin has direct antiviral activity in tissue culture against many RNA viruses. Ribavirin increases the mutation frequency in the genomes of several RNA viruses and ribavirin triphosphate inhibits HCV polymerase
in a biochemical reaction. Antiviral Activity in Cell Culture In the stable HCV cell culture model system (HCV replicon), ribavirin inhibited autonomous HCV RNA replication with a 50% effective concentration (EC50) value of 11-21 mcM. In the same model, PEG-IFN α-2a
also inhibited HCV RNA replication, with an EC50 value of 0.1-3 ng/mL. The combination of PEG-IFN α-2a and ribavirin was more effective at inhibiting HCV RNA replication than either agent alone.

"Have I been negatively impacting treatment by not taking Neup shots on time?"
No

"I thought Riba caused low WBC"
Actually it is the interferon that is causing the drop in WBC