Treatment Side Effects Progression?

[rainypass]

I was wondering about the progression of side effects during treatment, if the sides are mild during the first few weeks do they stay mild or can the sides get increasingly worse during the duration? I am now on week 4 of interferon/ribavirin for 24 weeks. I have heard things get more difficult and was wondering what to expect. I understand the sides can really vary from person to person.

When do blood counts typically drop?  This riba rash I keep hearing about when does that typically show up?

So far things are going well for me and the latest blood work shows I'm UND!!!!! My WBC is at 3.5 a bit low, and RBC 4.3 and Hgb 13.1 is holding steady. These are my week 2 results.

[coeric]

i was told to take tylenol after the shot to manage the fever and body aches. and you are probably aware of the importance of drinking plenty of water.  i tried to drink 100oz per day.

[coeric]

welcome to the forum. there are African-Americans that have posted here. you might want to start a new thread with African-American in the title to get their attention.  I just finished 48 weeks treatment with incivek.  the physical side effects including skin rash and anemias were the worst early in the treatment.  the mental and emotional side effects started at about week 12 and lasted until near the end of treatment.  with a good doc the side effects are manageable.
eric

[Dsw52]

Hi everyone,

I just began treatment least Tuesday, finishing my first week tomorrow.  I am on Riba and Interferon in about a month I will begin taking Victrelis as well.  So far my tx's have been manageable. The first day was awful because I took the shot...the next two days I had mid headaches and body aches.  I feel completely fine now.  I am thinking Tuesday will be dooms day once again.  Does the tx's usually progress as treatment goes on?  I have read horror stories so it's hard to prepare myself.  Also do most people work through the treatment?  Lastly, is anyone on the thread African-American... I know treatment isn't as successful for us, but wanted to hear people's opinions/journeys.  

Thanks guys! And I apologize if this is too much.  I am new to all of this. :-)

[1oftheclub222]

I am on dual therapy, just finishing week 10.  For me, sides are not as bad as I thought they would be, but I do get tired...and a ltitle more tired as time goes on.

At first I had maybe 2 or 3 days that I was pretty tired and the rest of the week I felt pretty good.  Now I get pretty tired for about 6 days, then I have one good day which is shot day.  I do my shot at night, but in the day before that I usually feel pretty normal and get a lot done.  

My WBC/Neutrophils took a beating right from the beginning, but I am hovering just above rescue drug level so far.  My RBC/HGB have been slowly declining, every blood test they drop a little, but I am still in normal range for now, so hopefully it will just stablize.  

All in all, I think I have been pretty lucky as far as sx go.  I have heard some have it much tougher, so I am very thankful that I have it easy in comparison.

I still have 14 more weeks to go, we will see how I do as time goes on, just taking it one day at a time, but so far so good.  

I hope you keep stable and the sides are minor...sounds like you are doing pretty well so far!

[Bill1954]

The anemia that develops with HCV therapy is hemolytic anemia; it is a result of the ribavirin and is distinct from other forms such as iron-deficient anemia, etc.

http://en.wikipedia.org/wiki/Hemolytic_anemia

Rather than initially inhibiting the formation of hemoglobin it develops by premature destruction of red blood cells. Typically red blood cells are viable for ~100 days or so; ribavirin causes premature destruction; bone marrow production can’t keep up with this loss.

I can’t imagine wheat grass juice or any other dietary measures having any substantial effect. If your doctor feels you’re getting into trouble, he/she will intervene with appropriate measures, such as dose reduction/prescription intervention.

--Bill

[Sentinel13]

Hi Rainy: I'd say everyone experiences a drop in WBC & RBC while on treatment.

Looks like you are on duel therapy (just peg & riba). Your hgb is really good at 13.1. Hgb does not drop as quickly for people on duel therapy.

My experience is peg kills the WBCs and riba kills the RBCs.

I've never had an intervention for low WBCs so I won't speak to that topic.

I have had an intervention for low hemoglobin (intervention was Epogen/Procrit).

Your doctor will intevene based on hemoglobin and hematocrit (not RBCs) so monitor your hgb & hct.

The threshold for hgb intervention varies, but you might expect your doctor to intervene at about 10.0 hgb. If your hgb drops too much, your doctor might first chose to reduce riba, then possibly prescribe Procrit/Epogen, and finally (if necessary) perform a blood transfusion.

Cheers, GB

[bbj2856]

I take my 11th Inj on Sat. So far the inj. seems to be minor maybe little head ache but Thank God no muscle pains or lot of the severve side affects. I take the Reb 8 am and 4 pm this is when i get the low grade fever after each pill . I dntn have any energy and i just push myself to get up go through house and walk about every 30 min. Everything taste like copper or alumnium......nasty so drinking all this water is very hard. But I know God is watching over me and will heal me iof this dreaded desease..10/down 14 to go . God bless u and i pray your have no problems

[orphanedhawk]

The truly frustrating thing about this virus and tx is how extremely variable it is.
Some people never develop liver problems, others die of it.
The same is true for tx.
Being und means so early on means you have a very large chance of success. Congrats.

I had problems with my wbc but my rbc never got below normal. Some people have the reverse and others have problems with both.
It's frustrating but that's just how it is.

Wheatgrass can't hurt and I've heard of a few things for wbc but nothing I can attest to.
The problem is that the drop is from the meds, not from nutrition.
However, do be sure you are taking vit D, calcium, and a good mulitvitamin w/o iron.

The really horrible rash you hear so much about is from people doing triple tx. You don't have to worry.
You may however develop skin sensitivity or a rash. I found oatmeal based soap and lotions helped. I also landed up either cutting the labels out of my shirts or wearing them inside out.

Sounds like you're off to a great start. Hope it keeps up this way for you.
OH

[rainypass]

Thank you for the replies, it helps to hear others experiences. I seem to be having less sides with shot 4 so hopefully things will stay about the same and not get worse. I did have a rash the first week and used aloe vera gel and it went away. I keep getting itchy areas and apply more aloe that seems to stop the itch, I guess I am just hoping not to get the rash.

I am still interested in hearing more about how the treatment effects blood counts, do most people have drops in WBC and RBC? Is there anything that can be done to prevent this from happening? I have read that wheatgrass juice can help with anemia, has anyone tried this with good results?

[Dee1956]

Hi, I recently finished Incivek, peg , riba
From what I understand it takes 5 or so weeks for the Riba to peak.  It is difficult to say how you will feel as you progress. Everyone is different and I pray that you have an easier time of it. I am glad to hear that so far you are doing ok.  That is great news.  I would have to go back to my journal to see how I felt at 4 weeks.

[Bovary73]

Hi Rainypass,

I'm taking my 12th shot of interferon tomorrow and for me the hardest part was in the begining. I can't predict what the future will bring (still have 16 more shots) but I feel that the body somehow gets used to not being 100% and therefore it's easier now than the first weeks of tx. By the way, I'm on triple tx with Victrelis. I haven't had any rashes so far (I think people on Incivek have more rash problems). My hgb went down from the beginning, only after a couple of weeks. This is the hardest sx for me. Besides that, I'm ok.

Good luck to you!

[stormy456]

Side effects vary wildly from person to person.  Some people are hit hard from the very beginning of treatment through the very end. Some feel it more in the beginning (particularly if they're doing triple therapy.) and then it eases off when their just on SOC.  

My husband is almost on week 17 of triple, and his sfx varied wildly from day to day.  When he went off the  INC he felt the absolute worst of the entire tx.  Now he's really feeling pretty good most of the time.  He slows down a bit over the weekends (shots on Thurs. night) but all in all expecting smooth sailing through end of week 24.