I started at 154 and have been down to 48 and at the lowest, 39. There is such a thing as a platelet transfusion, but most docs fix it by reducing the peginterferon. I went to 84% of the dose at 48 and then down to 40% of the dose at 39. They automatically reduce your dose when you get down below 50. I was back up to 72 and still keeping with the 84% of dose. I was even off all meds for 4 days because my neutophils got so low and we could not find a pharmacy with neulasta in stock. I have also used procrit for low hemoglobin, I cleared the virus very early and so the reductions in peg don't seem to make a difference.
You want to avoid reducing the ribivirin, which causes the low hemoglobin. Studies found that reduced riba has more to do with failing to cure than reduced peginterferon.
Thrombocytopenia in Hepatitis C: Impact on Patient Management
Source: Treatment of Thrombocytopenia in Patients With Chronic Hepatitis C: Potential Impact on Treatment Candidacy and Outcomes - Click here to view
Posting Date: February 25, 2009
Abstract
As discussed in this review by Maribel Rodriguez-Torres, MD, CPI, thrombocytopenia is a common finding in chronic liver disease, complicating diagnostic and therapeutic invasive procedures and anti-HCV therapy in many patients. Available treatment is inadequate and mostly limited to platelet transfusions with associated adverse events and complications. Recent research has provided substantial evidence that activating megakaryocyte progenitor cells with cytokines or through activation of the thrombopoietin receptor stimulates platelet production. Therapies that target this pathway have been shown to reverse thrombocytopenia in patients with cancer, idiopathic thrombocytopenic purpura, and HCV-associated liver disease. In particular, an increasing understanding of the role of thrombopoietin in thrombopoiesis has led to the development of numerous agents that increase platelet counts. These novel agents offer thrombocytopenic patients with chronic liver disease an attractive alternative to traditional approaches, such as platelet transfusions with their associated risks, and data suggest that they may improve outcomes of anti-HCV therapy.
http://www.clinicaloptions.com/Hepatitis/Treatment%20Updates/Thrombocytopenia/Module/Thrombocytopenia%20in%20Hepatitis%20C/Abstract.aspx
I started treatment in the 40s. I have ITP which is a platelet disorder and haven't had higher numbers until recently. I had to get INVG before my biopsy to bring up my platelets. Now I'm in the 140s which is very strange. My doctors including my hepatologist and hemotologist can't figure out why.