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HCV Treatment Stopped
Nov 29, 2004

Dear Dr. DTD,

I have HCV Genotype 1 probably for the last 30 years. Last March, my lab tests were ASP 302, ALT 679, Viral Load 1.7 million. Liver biopsy in August, grade 1, stage 2. I started PEG Intron 120MCG .5ML once a week and 1000 mg of Riboviron each day in September. In the 8th week the nurse called and said my platelets were too low. I was told to reduce the interferon to .3ML which I did for weeks 8 & 9. At the end of the 9th week, I saw the Dr. and he reported that my liver enzymes were normal yet my white cell count had dropped to 1.3. He said he was taking me off treatment due to concern of infection; we would do a Viral Load in a week to see if I had cleared the virus. He reported that if I cleared the virus it might stay clear yet it would probably come back. He also stated that drugs used for increasing white cell counts during chemotherapy would not work for HCV. He also seemed to feel I would not be able to take the treatment again.

My understanding is my best chance to clear the virus is do the full 12 weeks before stopping treatment and if successful do the full 48 weeks.

I understood that the Riboviron was the drug responsible for reducing the white blood cell count so why wouldnt the Dr. reduce the dose of Riboviron to increase the white blood cell count before stopping treatment?

Also, the local Hep C clinic uses 3 different drugs to increase white cell counts in their patients yet my Dr. says they dont work?

I have now been off treatment a week now and I am very discouraged. I wanted to give this treatment the best possible chance to work since I am Type 1. Also, the Dr. states that I will not be able to retreat. I dont want to destroy my bone marrow yet I have endured the treatment this long. I would like to see it through. I a wait my Viral Load results and your response.

Thank you in advance. This is a great forum for information.

Response from Dr. Dieterich

Neither of those drops is a real reason to stop or even reduce the dose. You are correct that you have to take the medicine a full 48 weeks and really 12 weeks to tell if it is working. There are several medicines that work to raise your white count. They work very well with interferon induced lowered white counts! We use them all the time. As for the platelets, I would have to see the numbers, but we usually don't worry too much about them. It is certainly not true that you cant be treated again. However I might see another liver doctor if I were you who is more aggressive about treating side effects of HCV treatment! Good luck! DTD

Hep-B/Elevated ALT&AST
Autoimmune hepatitis

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