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HCV anemia
Apr 16, 2003

I am HCV and on Pegasys/Rebetol for 48 weeks. Going on my 12th week now. HGB value is down to 11. For how long is Procrit used to treat this anemia?

Response from Dr. Frascino

Hello,

Combination antiretroviral therapy with pegylated interferon (Pegasys) and ribavirin (Rebetrol) has shown remarkable promise in treating hepatitis C. Youve made it to week 12 already. Congratulations! The biggest problem with combination therapy for hepatitis C is the side effects of drugs. The interferon can cause "the flu from hell" and depression. Ribavirin can often cause anemia, leading to fatigue, shortness of breath, exercise intolerance, rapid heartbeat, headaches, difficulty concentrating, and more. You are becoming anemic. Your hemoglobin is down to 11 g/dL. The normal range is 12-16 g/dL for women, and 14-18 g/dL for men. Procrit is definitely indicated in this situation. Studies have shown that Procrit raises hemoglobin, correcting the anemia and consequently relieving many of the symptoms associated with it. Perhaps just as importantly, Hep C-ers who used Procrit to treat their ribavirin-induced anemia were able to better tolerate their hep C combination meds. With aggressive treatment of the medication side effects, like anemia, you have a much better chance of completing your full 48-week cycle of therapy. By doing so, youll have a much better chance of controlling, and perhaps even curing, your hepatitis C infection. (We refer to cure as a "sustained viral response.") How long can you use Procrit? For as long as you need it! The full 48 weeks, or longer, if necessary. Its a remarkably safe and very well tolerated medication. It does not have any drug-drug interactions or significant side effects. Its administered by weekly injections. Your hep C specialist should check your "iron stores" (blood test), as youll need adequate iron levels to manufacture new red blood cells. He/she will also monitor your response to Procrit and adjust the dose as needed. Congratulations. You are one quarter of the way to completing your full cycle of therapy. Hang in there! Write back if you need additional advice.

Good luck.

Dr. Bob


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