Being coinfected my Dr is doing to begin with weekly labs. I went yesterday after being on tx for only a week to do my labs and got them back today. Can someone take a look at them to tell me about them. I see my Dr again next Tuesday, but any insight you have will be appreciated.
Did anyone elses AST and ALT go high to begin with and then begin to lower after beginning tx? Are my ABS NUETRO'S (WBC'S) low? When do they normally begin to give meds for that? Your input is always appreciated.....
To be honest, I forgot all your stats including genotype. Also, it would have been helpful to know your pre-treatment numbers for these same tests...but here's a whack at what you've presented --
Enzymes -- a crude measurement of progress especially at week 1 although a sharp downward movement is always a good sign. Not sure if that's the case with you since we don't have previous results.
Hemoglobin -- Don't know what you started with, but I'd keep an eye on it weekly, not because it's low but because it's too high. If it doesn't start to move downward soon, ask your doc about more ribavirin as you may not be absorbing it optimally -- especially if your high hemoglobin coincides with elevated enzymes and/or a sticky viral load.
The rest including ABS: All look good although really never studied up on glucose or billirubin much. As to WBC and ABS Neuts -- the abs neuts is the only one that is important and many doctors let it fall to as low as 500 or even lower (my doc let's it go down to 200) so you're are very far from having a problem. Not sure how this relates to being co-infected.
Since you're having weekly tests, personally I'd ask my doctor to include a viral load test at weeks 2 and 4 and keep going every other week (or every week) until you become non-detectible. What you want is a very sensitive viral load test like "Heptimax" by Quest Diagnostic's labs.
Some doctors may look at you like you're crazy, but yeah, if you hemoglobin doesn't drop by your week 2-3 labs, I'd certainly mention it. As of now your hgb is up, not down. How much do you weigh, what is height and how much riba are you taking? Also, if it were me, I'd push hard for the week two viral load test cause as mentioned ALT is a crude measurement. The earlier you really know if treatment is working (or not) the sooner you can make adjustments in drug doses, etc, or not. Good idea to take your riba with food with some fat as lady said. Also, don't take antacids or fiber supplements within a couple of hours of the riba dose.
Those counts including WBC are pretty good so far. Mine got as low as 1.8 during my last 8 weeks of therapy, but I kinda rebounded. WOW, CD4=602. I haven't seen my numbers that high in a while. What is your CD4%? There is an actual number then there is an overall %.
My HEMATOCRIT was at one point 36.0. My ANC was at 800. I never got put on the rescue drugs thank goodness. Since I stopped all those numbers have came back normal.
Not sure what is going on with the ALT, but I would definitely consult your doctor.
By the way Rick, what is your cocktail? I think I remember Reyataz, but what are the other pill(s)?
Hang in there dude... You never did contact me or email.
Rick are you on pegasys? Also are you trying to take the riba with food that has a good fat amount to absorb the riba? I'm pretty sure the pegasys drops the wbc's the quickest, while the peg-intron drops the Hgb/red blood cells. I don't know about the other numbers, I just told someone on community that it's too suspenseful getting weekly labs, more to worry about!
Prayers for you,
I agree with Jim, your Hgb seems pretty high after taking Riba, but you are only on week one! So post your labs again in a few weeks. My Hgb went down after about 3 weeks and there are those here that believe the Hgb should drop for you to know if the Ribavarin is working. I wish I had your labs, otherwise! My LFT's (liver function tests) didn't go down all at once, they went down a bit more gradually. Some have ALT/AST's that go up and down during tx, so perhaps not to worry? NOt dr's here, just diligent and obsessive patiens. Given your history of Hiv and being co infected, I am not sure of all the differences in lab work. I agree with Jim, PCR's as often as possible at the beginning of tx would be the best test you can do! This way you will be able to tell if the tx is working.
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