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Post Info TOPIC: Please help...
Phil G


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RE: Please help...
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My Riba was reduced to 600, but not until week 17 when HGB dropped to around 9. My WBC got as low as 1.9 but bounced around a lot. The guidelines I have seen suggest reductions at 10 hgb and 1.5 wbc.



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Geno 1A, VL 1.9 mm, SOT 12/2/11 - Pegintron/Ribavirin/Victrelis, UND since wk 8, EOT 6/15/12 (28 wks), SVR 11/30/12
turtles


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I also don't know about Victrelis, I was on Incivek with Riba, and started w/180 Peg.

 I went 12 weeks Then my red blood cells droped so low I had to be transfused. They reduced my Peg. to 135 and Rib. to 600mg.

I also was real freaked out,but however my next viral load test came back undetectable. My doctor even told me that he thought it was not nessasery to start patiants off with such high doses. I did use procrite for six week and it did raise my counts up to normal (another injection drug.)  So I went another 2 months  undetectable then my blood platelets droped way down so they lowered my dose of Peg. to 90mg for two weeks and my platlets even droped lower, I had to go in for an emegency transfusion, 6 unit, I thought I was going to die. Just listen and do what you'r doc.tells you,If you'r blood counts go to low It can cause heart problems, strokes and even death. You'r doctors wont let that happen.

There are new treatments coming out soon thats supposed to be alot easier,thats what I have to wait on, but for you I hope you continue with great success. best of luck ..............................TED

  Hep. C genotype 1 cirohhsis stage 4 viral load 6,mill



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Ted...HCV genotype 1 cirrhosis stage 4  PEG,RIBA,INCEVEK taken off treatment after 20 weeks,low platelets,playing the waiting game..
HazeySask


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I don't know about Victrelis, so I won't comment on it.

As long as the medications are in your system, they're working and doing their job. Less of it, is not necessarily a bad thing... That's less strain on your body, and giving your body more ability to fight back. Those white blood cells are extremely important, so better to get them back up with less medicine than have them low with more medicine...

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Genotype 1 :: Treatment Started 09-JAN-2013 :: Ribavirin - Peginterferon - Telaprevir :: VL UND Week 6
wkt


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Hi all...It's been awhile since I posted. This whole hep c thing is a real time consumer. I do appreciate all the kind words of advice you gave me prior to starting treatment. It means a lot because I can see how much experience there is on this forum. So...for today's question...

I started 180mcg Pegasys and 1000mg/day ribavirin on 1/19/13. I'm supposed to start Victrelis this weekend. Monday of this week I had my first labs drawn since beginning treatment. My doctor's nurse called me today to say that my WBC came back "low" and they're reducing my ribavirin to 600mg/day and my Pegasys to 135mcg. I'm only 3 1/2 weeks into this!!! I feel like I've read nothing on the internet but NOT to go for letting your doc reduce dosage this early in the game. I'm completely freaking out. It hasn't been easy at all, but I'm not prepared to quit or give this thing less than my best shot. I just don't know what to do. Trust the doc? Or, argue with him about not lowering my dose? Isn't there Procrit and Neupogen to treat blood counts? And, isn't Victrelis supposed to be even worse on blood counts? I haven't even started that yet! 

I guess I'd really like to know if there are any people out there that are genotype 1b that achieved SVR with only 600mg ribavirin/135mcg Pegasys from before week 4???



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mallani


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Hi Wendi,

Reduction in both Peg and Riba at this stage seems a bit premature. Do you know what your WCC is? Normal range is 4-10 x 10/9 per litre.

HCV patients on Rx usually drop to around 3. A drop to ~2.5 may mean Neupogen or Peg reduction should be considered.

Dropping your Riba dose makes no sense. It has no effect on the WCC.

Adding Victrelis can cause additional reduction in Hb, WCC and platelets. This is very variable and until you start Vict. you have no idea.

Studies have shown that reducing doses in the first 12 weeks of Rx can have adverse effects on SVR. I would not agree to any reduction unless my WCC was <2.5 .



-- Edited by mallani on Thursday 14th of February 2013 01:34:49 AM

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Geno 1b, IL28B CT,  x3 prior relapser,  ex-cirrhotic, 75 yo, did 48 weeks with Victrelis/Peg./Riba.  VL 1.28m at start, UNDET. at 8 ,12 ,16 ,24 ,30  and 48 weeks.  EOT 15 Feb 2013 , UNDET. at EOT + 28 weeks. SVR!  Still Undet. at EOT +5 years

Malcolm
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