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Low WBC before treatment with Hep B

I'm dropping in from the Hep B board. My brother was recently dx with CHB and his labs show low WBC, high RBC and low neutrophil count.  Would you expect this in a hep infection or does this indicate something more sinister?  We are awaiting viral load.  His ALT is 55.  Thanks for any help.
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Avatar universal
From Mayo Clinic

Although a high red blood cell count is not a specific disease, it may be a sign of an underlying problem. Causes include:

Living at a high altitude
Congenital heart disease
Failure of the right side of the heart (cor pulmonale)
Scarring and thickening of the lung tissue (pulmonary fibrosis)
A rare bone marrow disorder (polycythemia vera)
Dehydration, such as from severe diarrhea or excessive sweating
Kidney disease
Exposure to carbon monoxide
Anabolic steroid use

In severe cases, a high red blood cell count can impair circulation and lead to abnormal clotting. Treatment of a high red blood cell count is directed at the underlying cause.


Sometimes the cause of a low white blood cell count can't be determined (idiopathic). Known causes of a low white blood cell count (leukopenia) include:

Infections, such as viral infections and HIV
Autoimmune disorders, such as lupus
Certain medications, especially those used in chemotherapy and some antibiotics
Radiation therapy
Bone marrow disease, such as leukemia or myelodysplastic syndromes

White blood cells help fight infection in your body. A normal white blood cell count ranges from 4,500 to 10,000 cells per microliter of blood. A mild decrease in white blood cells below 4,500 cells per microliter doesn't necessarily indicate a serious illness. However, a dangerously low white blood cell count — below 2,500 cells per microliter — increases the risk of serious infection.

Hope this helps
Avatar universal
I have read that African American and some Hispanics often have a low
neutrophil count from the start.

My treatment was stopped Friday because my doctor said I had a dramatic drop in my neutrophil count.

I was prescribed meds to help raise the count and avoid infection.
I am over the top with disappointment because I was dealing pretty well with the physical side effects, and my enzyme levels dropped significantly in two weeks.

Unfortunately, I don't know my numbers . I will try to get them today and do some more research. If I find out anything I'll post it for you.

If you find and additional info please post it.

I was not sure sure if my doctor was being overly careful or if I was in big trouble.
I would have preferred reducing the dose.

Now I am trying to find out if the Neutrophil count can be increased with meds during treatment and maybe I could get a few more weeks in.

I don't think my doctor was really prepared for my dramatic drop.
Avatar universal
Thanks for the information!
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