Eight weeks into the incivek treatment and my anemia is kicking in! WBC/RBC/hemoglobin/hematocrit counts are dropping, although not horrendously low. Liver enzymes are hovering at normal (AST) and slightly above normal (ALT--actually went up 3 points, but that is likely a statistical fluke). The troubling parts are other signs of anemia: slight aniso- and poikilocytosis; and, potentially scary, slight toxic granulation and the presence of vacuolated neutrophils--which could indicate massive bacterial blood infection but most likely are yet another side effect of the damn drug. Yes, my immune system is compromised right now--funny,, considering that some of the meds I am taking are actually immune system boosters--but only in a very narrow way. In any case, since my doctor is not pulling me in to stick me onto an antibiotic regime, I suspect this is all within acceptable limits. Or perhaps they will pull me in today! :)
More on rashes: interestingly, they are apparently fundamentally allergic, and are triggered by overproduction of eosophils. It is funny that my drug cocktail suppresses the production of some blood cells while increasing that of others(and the chances of abnormal ones!). Still, only 3.5 weeks to go on incivek--after that things should get better. If my anemia keeps on getting worse, perhaps they will reduce my ribavirin dosage.
Speaking of ribavirin, reading a batch of monographs I find out that nobody really knows how it works! There are several postulated mechanisms, but none confirmed. The fact that is DOES work is not in doubt--for some diseases, like those nasty hemorrhagic fevers, it often gives the patient the only chance for survival--but it does so in mysterious ways. (As opposed to incivek, the action of which is quite precise--and the side effects, much more diffuse and general).
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