worried..WBC 2.0 only 24 days in TX

before teatment my WBC was 4.0.....norm is 4.0-11.0......my RBC before were 3.86...norm is3.50-5.10...now after 24 days into treatment with 400 mg ribaviran and pegasus injection 1 x week,im HCV,genotype2.have to treat 24 weeks.im so tired,and bad headaches....whats do i do about my low WBC that is NOW 2.1    !!!   RBC is now 4.36.i have been eatting red meat to get iron to keep RBC up, but dony know what to do for a 2.1 WBC.just founf out today,and doctor will not be in till monday! how professional.....is procrit for low WBC ?

[gauf]

No, Nuepogen is for low WBC. Take it easy until Monday when you can talk to your doc. My WBC is 2.8 and I am not currently on tx. I feel fine so you should be o.k. short term. Take it easy on the red meat because the virus loves iron.

[jmjm530]

More important than WBC, is the WBC franction called ANC (absolute neutrophils). The value is probably listed somewhere with your lab results. WBC 2.1 isn't that low, so hopefully your ANC will also be in range.

Sounds like your RBC has actually gone up on treatment. That's odd. Do you kno what your pre-treatment hemoglobin was and what your hemoglobin is now? Also, you say you're treating with 400 mg/ribavirin. I assume that's twice a day, for a total of 800 mg/day?  How much do you weigh as geno 2's are now often being treated with weight-based ribavirin.

Lastly, have you had a viral load test done yet? It should have been done at week 4, but if not, ask to have one done ASAP.

All the best,

-- Jim

[PRINCESS5121]

thankyou..............i was eatting more than usual red meat and eggs,as to get natural sourse of iron,not supplements to try to up my rbc and it worked............my NEUT % SAYS 33.9...NORM is 40.0-74.0............my hemoglobin beofre was about 12.0,now 13.4......im only day 23 into treatment,going to have lab script mailed to me to get viral load test done to see if it came down,right / thanks............i also called dr office back,dr will return my call by dinner............what are we do do in addition to rescue meds for WBC being low ?also, yes riba 2 x daily.im 5ft 5 and weigh 155.all the best to everyone,and thankyou for responding !

[jmjm530]

Your neuts look fine, and again, it's odd that your hemoglobin is actually higher than before treating.  I would get a viral load test ASAP to see if the drugs are working. Your doctor should have ordered one at week 4.

-- Jim

[jmjm530]

princess: what are we do do in addition to rescue meds for WBC being low ?
----------
Missed your question. As mentioned, ANC is the important number and your ANC is not low for being on treatment. We're not doctors here but I don't see why you would need any rescue drugs, but of course that is a decision for your doctor. More compelling IMO is for you to get a viral load test right away to see if these drugs are working. It may turn out you need more ribavirin, given the absence of anemia in spite of being on treatment. This isn't necessarily a good thing because anemia can suggest the ribavirin is being absorbed properly.

-- Jim

[Lady Lauri]

  Very odd her Hgb went up!?
I think she's saying that she's at day 23...so 4 week labs need done now.


Princess...others will tell you also...lay off the iron, helps the virus replicate.
A catch 22 for us with low Hgb.
Good luck in your 4 weeks test.
                                                                 LL

[MYS]

Hi, I'm new here, but not new to Hep C.  I was a type 2 also, did the treatment last winter, now i'm supposedly clear of it (SVR).  
Red meat, eggs, etc., the normal things you think of eating for anemia are not good while you're on interferon/riba.  The occasional steak won't hurt, but the type of anemia that happens while on Hep C treatment can't be cured with iron rich foods, and they may even make things worse.  Procrit works for treatment induced anemia, which it sounds like you don't have.  Neupogen is prescribed for low WBC and ANC.  Insurance companies are much more likely to authorize Neupogen than Procrit.  I was on both.
You really do want to have that 4 week viral load (PCR )test done, preferably on day 27 or on day 28, but before you do your 5th injection.  As a type 2, the chances are good that you will test clear then, that will make the rest of your treatment a lot easier on you psychologically, knowing that it's working and that you're a Super Responder.
All the best,
MYS

[jmjm530]

Right, those are her week three labs? but still odd that hemoglobin is up, not down from pre-tx at week 3. Hopefully, viral load will be done at week 4, which means blood should be drawn for viral load the day before the fifth injection, or day of the fifth injection but before the injection.

-- Jim

[jmjm530]

Not sure I agree with everyone who says lay off the red meat, eggs etc, on treatment. As long as her serum iron and iron stores (ferritin and TSAT) are normal, I don't see a major problem, especially if one is trying to maintain weight and energy -- not that they will have much of an effect on hemoglobin. Iron supplements are another story, and should not be taken. Same as cooking with iron cookware, according to some.

-- Jim

[PRINCESS5121]

i think my RBC went up because iwas eating too much red eat and eggs,trying to prevent anemia,but now i undersand thats not the answer ! rescue drugs are the answer if dr saysi need them.im going to have my 5th shot tues...i better get a script faxed to lab on monday for my viral load.i was looking on my firstlabs too,and i do not see the term PCR test.could it have been under another term /first testing b4 treatment was tested for   HCV Quantasure Plus (serial)
hepatitus (hepatitis) quantitation 6,590,000   IU/ml         02
HCV log 10               6,819         log10  IU?ml       02

PT AND PTT 1.0 norm 2.0-3.5
    INR

also mistake on my hemoglobin.exact before figures were12.7...and now....13.4 but still went up...

i have no clue what these things mean but WBC,RBC.and hemoglobin.is the hep quan. my viral load? thanks all..........

[jmjm530]

Yes, the Hep Quant (HCV Quantasure Plus) was your viral load test.  If your fifth shot is tuesday, try and make it a point to get blood drawn for viral load either Monday or Tuesday. If Tuesday., make sure the blood is drawn before the injection. You want to double-check this because just because they draw blood, doesn't mean they necessarily will do a viral load test.

-- Jim

[PRINCESS5121]

i think i ned a new dr.he returned my call last night.he told me i dont need any meds at this point with the WBC being 2.1,and he was ok with my neut as well,and hemoglobin,and didnt seem concerned at all about RBC.i asked him if i should have blood done before my next shot and he hollard at me asking where am i getting this info.he dont do viral load check agan till 2 months into treatment.i told him i was concerned about my cronic (chronic) fatigue and low WBC.he told me to not inject ful syringe,empty it out to the 135 line he said,so hes reducing pegasus abount.but yet i asked him something and he screamed at me not to screw with my WBC being dangerously low,but yet dont put me on a rescue med....im so confused that im scared to death to give injection next time,that my white cells will go down more.then what.he tells me you can friggen die you know if you dont listen to me..........im going to ask for his partner on monday.im so worried......

[jamimapuddle]

   A lot of docs wait till it gets real low. Don't worry, I would ignore the doc about reduction if you can, your not at that much risk with a WBC 2.1.  I've heard a lot of docs wait until 1.5.  My stepdad is a surgical nurse (which is not necessarily an expert) and he said your not at risk of the real serious infections until below 1.  
    My WBC tanked in the beginning too, and then it went back up.  It does sound like you need a new doctor though, he seems like a primo jerk.