HCV Treatment

[dev0583]

Hi Sir/Madam,

My mom is going HCV treatment from last 19 weeks . She was very down with platelets count ranging from 24,000 -  50,000 , though her RBC and WBC were in normal range earlier 12.5 and 5500 before starting of treatment . But now after 19 weeks treatment of interferon 180 /ribavarin 200
her RBC has come to 7.7 , platelets to 24,000.

In between the treatment she was also injected Mircera 100(for RBC) and Neupogen 0.5 ml (for WBC) and platelets transmission which marginally boost up the respective count.
But condition right now never appeared earlier where even after given Mircera 10 days back RBC still holds at 7.7.

Is there anything which is still in dark to us and v should be aware ? Would be very gr8 full if you can guideline/suggest me on same.

Details :
Genotype : 3
Viral Load : 7,50,000
interferon/ribavarin shots done : 19
interferon/ribavarin shots left : 05

Regards,
dev

[FlGuy]

Generally, Inteferon affects the white cells (Neupogen is used) and Ribavirin affects the hemoglobin (Mircera is used).  Once treatment ends and the drugs are out of her system the blood counts should go back to where they were before treatment.  Ribavirin lasts a little longer in the system (a few weeks) than Interferon (a week or two).  So, shortly after treatment end she will probably not need those two.  The more curious is the platelet level. 24 is pretty low and the platelets transfusion makes sense.  But, what was her platelet level before treatment started?

[dev0583]

Mircera once a month and Neupogen around twice a month .. yes she does gets her blood count weekly or atleast once in 15 days ..

Five weeks seems to be very long for us ... Can you let me know when can I expect my mom's blood counts to get normal after end of treatment ?

[Fnzol]

How often does she get her injections of Neupogen and Mircera?  Is she getting her blood counts checked regularly?

Also, make sure that she takes her pills regularly and doesn't miss a dose.  

Five weeks to go.  You can do it.

[dev0583]

Yes FIGuy , her genotype is 3 . Other then start of treatment no viral load test has been conducted since our doctor is very much in confident on his treatment and progress results(except last result) since her OGDscopy  also turn out to be normal . You are correct on ribavarin as well but she take 800 mg daily ( 2 morning and 2 night) .
Are the blood low counts (RBC , WBC ,platelet) will continue to be low even after end of treatment. When can I expect them to get back to normal since the treatment has already stressed out alot. Will going for Viral load should be my next step ? Please do share your valuable inputs on same.

Sorry for bothering you with so many ?'s but hope you understand my nervousness on this situation . Thanks

[FlGuy]

With the additional use of Mircera, Neupogen and platelet transfusion (transmission?) it seems that the doctors are doing the right things to try to keep her on treatment.  Since she is planned for 24 weeks of treatment, it implies that here Genotype is 2 or 3 and the data you provided also implies that her liver is not in great shape at the beginning.

In the first several weeks of treatment did she have viral load tests to determine if she is responding to treatment?  If so, when in treatment was the test(s) and what were the results?  You wrote "interferon 180 /ribavarin 200".  If the 200 means 200 mg. per day of riba that's a very low dose and is probably explained by the need for  Mircera.

[dev0583]

Adding more info on above she has also gone through OGDscopy which turn out to be normal and also gone through sonography which shows Mild spleenomegaly (12.8 cm).

Since I am newbie on this forum please do apologise me if have deviated from any kind of rules of forum.

Regards,
dev