low haemoglobin before tx

[jessiejames1973]

Hi All,

i have recently been diagnosed , iam looking at tx asap, as i have symptoms and a high VL 11 000000, My ALT  is 200   i have not spoken to a specialist yet, but  iam worried about my haemoglobin level which is , 12.6  its been this level for years , this i know because i have been keeping an eye on it since it flagged up three years ago, the reason iam worried is because i have read this is a reason for tx being stopped, so if its low to start with , what are my chances of completing tx?

Regards

[copyman]

first do not panic. this disease is usually slow moving. no need to rush into tx.

your high ALT & VL does not always mean you have severe liver damage.

the best course of action would be to see a Hepatologist (liver specialist) and set a plan.

You should find out if you have any liver damage and if not that severe then wait for the new drugs coming out in 2011

good luck

[copyman]

as for the low HGB. there are drugs that you can take to increase HGB while treating

[GreatBird]

12.6 isn't terribly low. My Hgb usually hovered around 12.9-13.5 before tx. (We're all like that in my family.) Once you get on tx (I agree with copyman--do the research before you jump on the tx bandwagon), there are drugs they can use to boost Hgb if yours drops below 10 (which is usually the cutoff). Procrit is an injection and it encourages red blood cell production. It is important to have a doctor who will prescribe procrit instead of reducing the ribavirin. You might want to ask the new doctor their philosophy on that.

Do you know your genotype and what condition your liver is in?

[newleaf09]

On my lab reports, normal is 11.6-16.4.  Laboratories differ one from another.  Sure it would be a little better to go in higher, but it doesn't make much difference.  Everybody's hemoglobin drops due to the ribivirin.  There are 2 "rescue drugs" that are used with the interferon/ribivirin combo used to treat HCV.  One, epoetin alfa (called Procrit or Epogen) stimulates the bone marrow to produce extra hemoglobin.  The other, filgrastim (called Neulasta or Neupogen) stimulates bone marrow production of neutrophils, an important white blood cell destroyed by interferon.  Most patients tolerate them well.  It's good to have decent insurance, since it is always better to use the rescue drugs instead of reducing the dose of either interferon or ribivirin.  It's just one more thing to consider when planning to treat the virus.

[jessiejames1973]

thanks for your replies

I dont know genotype just yet as they had not come through, only LFT test and VL, cos i feel like my liver is bouncing round inside me and iam knackered all the time (the reason i got tested) coulped with high figures i assumed my liver is damaged, iam waiting to see a specialist, and i am very scared as to what else i am going to find out,

best regards
James

[nygirl7]

Jessie,

A good hep doctor in coordination with a good hemotologist would be a good way to go if you find out you have liver damage that would require treatment.  
The one thing you do want to make sure of should you decide to treat is that your doctor will manage any hemo with the rescue med Procrit but NOT by dose reduction unless absolutely necessary and hopefully after week 12.  Staying on the full dose of meds is VERY important for your success rate.

Aside from the Procrit and dose reduction people have had transfusions to deal with the hemo problem - but thats really a last resort.

Like I said, you could be one of the people it doesn't bother at all - unfortunately no one can know until they do treat.  Like copyman said a high VL means nothing really. Get yourself your biopsy and see if you do have liver damage that would require you to treat - otherwise you might have time to wait until the new drugs are approved with shorter treatment lengths.

What genotype are you?  24 weeks is WAY different than  having to do 48.

[jessiejames1973]

nygrl7
thanks for the reply
I dont know genotype just yet as they had not come through, only LFT test and VL, are liver (area) pains a sign of damage?
i have highALT suggesting inflammation, does inflammation mean permanante damage?
thanks
jessiejames