I'm on week 11 - Peg interferon and riba for geno type 2 (24 week course of tx)
As some of you may know I have had some bad luck with my heart. Two weeks ago I was aware of alarming shortness of breath and weakness. When I saw hepetologist Tuesday 20th he told me I was suffering from acute anemia and I was sent immediately for a blood transfusion - 3 pints to fix low hemoglobin,
Although I don't feel as weak as before the transfusion I notice I am still short of breath and although RBC and hemoglobin have risen I see from blood tests my WBC has fallen to 2.5 and platelet count fallen to 53 from 63 in a week. Anyone know when they strike you off peg and riba because of low WBC or platelet count. I'm 180 peg and 4 riba pills per day at the moment.
This is from the PEGASYS (peginterferon alfa-2a) Package Insert -
"Dose reduction to 90 µg PEGASYS is recommended if the platelet count is less than 50,000 cells/mm3.
Cessation of therapy is recommended when platelet count is below 25,000 cells/mm3."
Ultimately it is really up to your treating doctor and what they are comfortable with.
For us cirrhotics for example, instead of stopping we will be given by our hepatologist either a platelet transfusion or Promacta when our platelet count drops below 25,000 or 20,000 because if we don't clear the virus, it may be our last shot at treatment before we are too ill to treat our HCV.
By the way, you have plenty of platelets so there is no danger as far as clotting and bleeding. Unless you have other coagulation issues which would be seen by your INR test results.
If your platelet counts gets very low you will notice intermittent nose bleeds that take a long time to stop and bleeding gums after brushing teeth. You may also bruise more easily and notice little dots of blood under your skin. I've experienced all this and while not usually a serious issue you should mention it to your doctor. Many of cirrhotics normally have platelets in the 50s-60s for years with no issues. I've had platelet counts in the 50,000s for over 5 years.
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