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Epogen vs. Procrit vs. Natural EPO
Apr 1, 2002

Can you discuss anemia in relation to available treatments I've listed for HIV population? Is there a natural source of EPO available that is not recombinant derived? For HIV population, what are the concerns from recombinant derived EPO?

Response from Dr. Frascino


EPO vs. Procrit vs. natural EPO for treatment of HIV-related anemia? Sure, I can discuss that.

Erythropoietin is a naturally occurring hormone produced by the kidneys. It helps stimulate bone marrow production of red blood cells, thus increasing hemoglobin levels and alleviating symptoms, such as fatigue, that are associated with anemia.

In certain medical conditions, such as chronic infection (HIV) or cancer, or with certain medication side effects related to treating these conditions (AZT, cancer chemotherapy), the body is unable to manufacture enough erythropoietin to meet the demand, so we can become progressively more anemic. The only treatment in the past was a blood transfusion. However, we now know blood transfusions can cause problems, some of which are particularly worrisome for those of us with HIV. For instance, we know that blood transfusions cause further immunosuppression and can increase HIV viral load. The effects of blood transfusion are also only temporary. Certainly, they have their place in the treatment of anemia, but are now usually used only if the anemia is extremely severe, such as rapid blood loss from a traumatic accident or a date with Count Dracula, for example.

Procrit is the brand name for recombinant erythropoietin. It is manufactured by recombinant DNA technology and has the same biological effects as naturally occurring erythropoietin. It's self-administered weekly by injection just under the skin, using a very tiny needle. It's been used extensively to treat HIV-related anemia for over 10 years with excellent results.

Is there a natural source of EPO available that is not recombinant-derived? No, however, as I mentioned, Procrit is identical to naturally erythropoietin.

For the HIV population, what are the concerns from recombinant-derived EPO? That's the really good news. Procrit has a proven safety track record. It has essentially no side effects, and does not interact with any other medication, including all our HIV meds. Of all the things we have to take for HIV or that we use to manage side effects related to our drugs, Procrit is unquestionably the safest. It's also remarkably effective in raising hemoglobin, thereby alleviating the symptoms of anemia. Clinical trials have conclusively shown it improves energy levels and quality of life. It also is associated with improved survival.

Hope this helps! End of discussion! Unless there are more questions, of course!

Dr. Bob

CMV before HIV?

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