Hgb too high?

[flcyclist]

I recall reading some posted studies that supported the theory that a 3 point drop in Hgb indicated a good saturation of Ribavirin and a higher % chance of RVR and ultimately SVR.  Please correct me if I got that wrong.  

I’m a bit concerned that I haven’t seen that drop.  My Hgb started at 14.1 prior to trt and generally hovers around 12.  On Monday was 12.0 and today was 13.0.  (Billy, I wish I could send some your way).  

Have many who’ve trt with SOC seen higher Hgb levels like this?  I’m beginning to think it might be worth considering raising my current, 1200 mg Ribavirin/day, to 1400 mg.  Am I asking for trouble and should just continue doing what I’m doing?   Believe me, I’m not looking to make this any more of a struggle, but just want to do this one time.    

I started with a low VL of 24,000
UND at 4 (RVR) and 12 weeks - currently at end of week 17
1200 mg ribavirin/day, 180 mcg Pegasys/week.  I'm 185 lbs
ANC tanked to 325, so on neupogen 2x/week.  

I have an appointment with my GI and would like to receive some input if you have some knowledge or experience to share.  It appears with my low ANC and high Hgb, I’m tolerating the ribavirin, but the interferon is kicking my butt.

Thanks.......

[oceanblue701]

I started with a HGB at 14 something, went down to 11 and sat at about 11.8 for the rest of treatment. Same SOC.
Original viral load was 150,000.
RVR the day after 4 weeks of tx ( no testing prior to that) and at week 12 too.
Low WBC for me, but cannot remember exact number, maybe 2000.
My Dr. thought the RVR was the best predictor of outcome and felt chances for SVR were in the 90s for me. I hoped to God she was right.
I was SVR 7 months after tx ended. (too afraid to take the tests before then)
I think the association with HGB drop may be coincidental as this effect is expected to occur at various levels with all individuals. I cleared with a fairly high HGB so if there is a correlation it certainly doesn't mean SVR is exclusive in individuals who maintain a 3 point drop and lower.
I would not up the Ribavirin , you are doing just fine according to the statistics. Increasing the Ribavirin could cause trouble. Hang in there.

[Trish77]

I'd not push it with higher riba either....RVR trumps just about everything and you're already dealing with low whites.  You've got great adherence and still able to cycle.  Pushing up your riba could change all that and for dubious benefit.  I tend to think you're already on the right track.  That's my penny's worth.

Trish

[frijole]

You got it, flcyclist!

[flcyclist]

Yep, we'll do just about anything for that extra EPO. :)

[Anne1717]

I don't know about those cyclists - just soccer players

[frijole]

We know all about you cyclists!

[frijole]

RVR trumps HGB

[flcyclist]

oops.  couple corrections i missed.  

numbers do jump around a bit.   ANC was down to 0.3 Monday, back to 1.0 Thursday, just prior to neupogen shot.

[flcyclist]

Thanks can-do,  I guess it kinda surprised me today when a saw Hgb at 13.  I realize these numbers do around a bit.  On the other side, my ANC was down to 3.0 Monday, back to 1.0 Thursday, just prior to the neupogen each day.  My hopes of dropping down to 1x/week don't look good.  Thanks guys.

[can-do-man]

Your a geno 1 on just SOC and was RVR at week 4? Man it just doesn't get any better then that.

And yes theres been others here that didn't have much of a drop in their HGB and went on to SVR, Rocker comes to mind there.

Best,
cando

[Anne1717]

ha ha ha  - you are such a funny guy . our pitching does stink, i'll give you that

[flcyclist]

Anne, just hoping for you.  Or maybe it was after Rays beat the Red Sox the other day, haha.

[researchmonkey326]

Well hopefully I'll be able to report svr with no anemia. Besides I've had enough other sx without looking for more

[Anne1717]

Too skeptical, old and wise to be left breathless over a guy - for now - we'll see how he turns out.  

[flcyclist]

Yes, I know, overthinking again.  I guess I just wanted to hear from a few that had their hgb stay above and went on to SVR.  Honestly, I'm not really worried, just a curiousity.

[flcyclist]

Good to see some things never change.  By the way, icould it be the new guy you're dating that is leaving you breathless?  New relationships can have that affect.  Just a possibility.....

[researchmonkey326]

Good lord, something else to worry about. I thought it was great that my hgb has stayed above 12 throughout.

[Anne1717]

NOT a serial hijacker - just a girl - hair flip

[willbb]

Well...maybe it is nothing more   than the lungs reacting to not wanting to smell the skunk  :)

Seriously tho...if your HGB is still low that can certainly cause shortness of breath ..hopfully you are getting CBC"s done often to see if  your HGB comes up and the shortness of breath dissipates.

cyclist...you already know beaner is a serial hijacker  and  now it seems to be getting more insidious as she is blaming her affliction on others...sigh

I apologize for her  :)

Will

[Anne1717]

Ha ha  - and now I will probably die of rabies from washing the slime off the dog just after beating HCV

[Anne1717]

Okay Will !!  Still quite a bit breathless, there's something weird with the lungs - not worried -  but I have plenty of energy.  AND - you most certainly will be blamed for this hijack - let it be known.  My dog killed a skunk last night so you know how it smells around here right now.  UGH

And - no big deal, and not at all unexpected, the EOT test was UND.

flcyclist - Hi !!! Sorry Will hijacked your thread and will try to blame me. After all, he is Canadian.

[Diane12855]

Going anemic isn't necessary to reach SVR... RVR as soon as you reached it is a great sign. You probably just have some great bone marrow that is able to keep up with the attack from the Riba. My anc didn't get low until after 24 weeks, but I was anemic by my 4th week. Everybody is different. As long as the virus is being killed... why worry about the rest?

Diane

[willbb]

HI beaner...How the H are you!!!

[Anne1717]

Well - if I can get HCV, then you can get pregnant!!!!

Will- - HIIIIIIIIIIIIII !!!!!!!