No change in platelet count on S+O Tx?

[mike716]

Hi, all.

I started therapy with Sovaldi and Olysio three weeks ago. I just got the results from my first blood analisis: the platelet count is still down around 100k, which is where it was before starting Tx, even though my transaminases (ALT and AST) have gone way down to the normal range.

Can anyone tell me if this is normal, that is, if platelets take a long time to go back up?

Thanks.

Mike

[AWorriedMom]

Yes, the platelets take a very long time. They are low in patients with a lot of fibrosis. Treatment does not change this. Time changes it if you get an SVR. So, it is nothing to worry about regarding where you are right now.

[Dee1956]

Hi Mike, congratulations for starting tx.  It sounds good that your ALT and AST have gone down.  How are you feeling?
Wishing you the best
Dee

[Dee1956]

I agree with Worried Mom, it takes a while for the platelets to go back up.  Mine did not improve until after finishing tx.
The good news is that yours are still where they were pre tx :)

[AugustineMama]

I finished up with S/O and my platelets are still low. I will have my 4-week EOT blood next week and hopefully my UND status holds too. My platelets have been in the 70-100,000 range for more than 5 years due to cirrhosis, but I'm hoping for a cure this time around. I would just like to kiss my husband. My gums bleed all the time and I'm afraid. I have excellent dental hygiene, but my gums still just bleed. Either way, I'm hoping it gets better

[flyinlynn]

Hi Mike

Have to agree with everone here. My platelets were low before and during treatment.

Hepatitis c does not effect platelet count cirrhosis does. Unfortunately curing hep c just stops the liver from any additional damage. There have been reports that once the liver is no longer under attack it can begin to heal itself and perhaps over time our platelets could possibly return to normal levels it just depends on how much live damage you already have how much function you can regain.

If we do have cirrhosis even after making it to SVR we will still need to be monitored every 6 months with abdominal ultrasound and AFT blood tests to look out for liver cancer. By curing HCV our chances of developing HCC ar also reduced but we are still at risk.

Congrats on starting treatment good luck

Lynn
Day 9 down, 159 dyas to go on Harvoni

[madelefant]

W

[Sarah1949]

I began tx with Sovaldi/Olysio with my platelets at 65. With week 4 labs they went up to 85 and at 8 week labs they were 80. Everything else in my lab work is perfect, just like a very healthy person - including AST and ALT.

[madelefant]

I treated twice with Ribavirin and Interferon and my platelets ere below normal during treatment but had been a bit above the low end out of treatment. After the last treatment my platelets stayed in low normal range but took a bit of dip just before we decided to treat again.  They have stayed normal all during Sovaldi and Ribavirin. I'd imagine it might take some time for your liver to recover and platelets go up ie your liver does some self repair if otherwise healthy.

[keepingOnkeepingOn]

Got a call from docs office. Says platelets still low but should improve over time- post tx S/O. Went from UD to NV to waiting for SVR.
Gums feeling better post tx as well as breathing better.

[bassetgirl]

I treated with S/O, reached SVR Oct. 23rd. I have cirrhosis.  My platelets have been in the low 60's since I was diagnosed last January. There was a slight increase in platelets at my 12 week EOT test in October, but nothing really significant.  My hepatologist says that over time my liver funcion and platelet situation might improve, so for now I'm just concentrating on eating a healthy diet to help my liver function improve as much as possible. Time will tell. Good luck with treatment!

[almostsixty]

Congratulations  on getting started and having your first blood check. I finished triple treatment about the same time as Hepc4Sandi. My platelet count dropped during treatment and very slowly came up after treatment. My AST is still slightly elevated and ALT normal. I have compensated cirrhosis and feel pretty good. You are doing well Mike.

[Livelife777]

Hi Mike.  I treated with Sovl/Riba for 12 weeks.  My beginning platelet count was 125.  During Tx my platelets stayed in the 200s.  After Tx my platelets went back to 118.  Kinda confused as to why that happened but platelets while on Tx can stay constant or fluctuate.  It is not indicative of response or whether you will SVR.  It seems that once Tx ends, they will return to where you began.  S/O seems to lower the counts for most.
It is also my understanding that it can take a year or more post SVR to begin reversal if any.  You don't finish Tx, and they then start improving.  It took a long time for them to go in a downward trend, and awhile for improvement should it occur.
Best wishes with Tx
.....Kim

[klonny55]

Hi Mike,

My platelets were declining for years. A biopsy in June 2013 showed F2-3 fibrosis. At this time my platelets were at 188. I finished 12 weeks of Sofosbuvir/Ribavirin in April 2014 and my platelets were 171. During treatment they shot up to 235 but as Kim mentions above they returned to previous levels, even a bit lower after treatment ended. 12 weeks post EOT in July 2015 my platelets were 155, just barely above the lower limit of normal of 150. I did achieve my SVR12 thankfully. in October 2014 at 24 weeks EOT they shot up to 192.  

So it took 6 months after I finished treatment for my numbers to start to rebound. If you have cirrhosis it might take longer. But I wouldn't expect any real change short term.

Hope this helps.

[1bucky]

Mike,
My platelets are real low 60,000 but my INR time is normal. My spleen is enlarged and is ripping up my platelets. Thankfully I have no bleeding problems. IDS said that my platelets may never be within the normal range but since my INR was normal to not really be concerned. I was given the OK to ski this winter and I have!
Bucky

[mike716]

Thank you all very much for your helpful comments. I feel relieved to know that others have experienced similar things with their platelet count. It really is tremendously reassuring to learn that one is not alone with these issues.

For those who SVRed, congratulations! For those who like me are still on treatment, I am sleeping with my fingers crossed for us.

Cheers.

Mike

[mike716]

Hi, Dee. So nice to hear from you. I'm doing okay so far, no sides except for the usual headaches.

How's life post-SVR?

A big hug for you.

Mike

[mike716]

Hi, Lynn.

I am so glad to hear that you got right onto Harvoni. I am sure you will SVR this time. My thoughts and wishes are with you, as they are with everyone here.

Mike

[hepcandme]

I am confused how to read the platelet lab results

http://www.mayoclinic.org/tests-procedures/complete-blood-count/basics/results/prc-20014088

When someone says their platelet count is 70,000, it's the same as another person saying 70?

It doesn't help that in my labs, the test results don't give a number at all. Only, normal, decrease or increase

[Aquisi]

Hi hepcandme, yes on my labs from quest they read as follows:

Test Name       Out Of Range        Reference Range Lab
PLATELET        COUNT 55 L         140-400 Thousand/uL

which means 55,000.

Regards,
Charlie

[1bucky]

Hi Charlie,
Is your spleen enlarged as well?
I used to freak out about my low platelets but a surgeon friend of mine said that since my INR was still normal that I could have surgery for something if needed. I live in the gallbladder belt and most of my friends have had theirs removed.
Bucky  

[Aquisi]

Hi Bucky, yes it was enlarged when I had cirrhosis, I am newly transplanted (10-28-14) and my platelets are back to normal after many years of being high...but that's a good question, never thought about that I'll have to ask my doc if it's still enlarged. Now I'm wondering if mine was removed, I know my gallbladder was. Thanks

Regards,
Charlie

[1bucky]

Wow, how lucky are you!!! I am new on this forum and did not know that you just had a transplant. My IDS and Hepatologist both said that we would wait a year and see how my numbers look. I have my SVR12 in two weeks so that is the next hurdle. If I remain UD and my liver heals some then there is a chance that my portal hypertension will improve and help out my old spleen. Besides a transplant which I don't need as of yet, the next thing that could be considered to raise my platelet count is to remove my spleen. We are all against that as the spleen is involved with the immune system. A good liver is needed if you loose your spleen and I don't have a great one of those.
Bucky

[flyinlynn]

Hi Charlie

Ok I am just a little confused. You said your platelets were high before transplant and are now normal?

I have F4 cirrhosis and my platelets are low at 90 ish. The lab my doctor uses say normal is 150-379 and that low platelets are common in cirrhosis due to portal hypertension and the resulting spleen enlargement resulting in sequestering of platelets in the spleen. So commonly people with cirrhosis at least what I have read have low platelet counts.

You

[flyinlynn]

Oops

And you posted your platelets as 55,000 which is low. Was that test before your transplant?

So anyway that is why I am confused.

But anyway congratulations on your transplant I hope you have many many health happy days in your future.  :-)

Lynn