Accuracy of Hep C test?

As some of you may know ( see my post under "need help with Hep c test" ) I still haven't gotton an answer to my problem. I've actually tested positive twice for hep c, since '97. Had a GI do a HCV RNA PCR test which came back negative, two weeks ago. Seems like my tests go back and forth, so that means nothing. I'm going to see a well known Hepatologist in June '06. Also going to see a Hemotologist tomorrow ( for neutropenia and elevated RBC ).
  I just came across this in the Quest website:
In this polymerase chain reaction (PCR) method, viral RNA is reverse-transcribed to cDNA and amplified with biotin-labeled HCV-specific primers. Amplification products are then hybridized to HCV-specific capture probes and detected with an avidin-HRP conjugate in a colorimetric assay. This test detects HCV genotypes 1a and 1b; the ability to detect other genotypes is currently unknown. Analytical sensitivity is 50 IU/mL.
CPT Code*: 87521

  Now, why would the doctor test me with a test that ONLY tests for genotypes 1a and 1b? No wonder I can't get any good answers. You'd think with several years of back and forth, something would have come of it by now. I'm glad I'm going to see both a hepatologist and a hemotologist. Maybe the pain will be gone soon, and I'll get an answer...finally!

[NYgirl]

It does test for all of the strains that must be very OLD information or something.  You have to remember lots and lots of stuff posted on the net was posted in like 1992 even...make sure you see a DATE somewhere when reading life changing articles.

The only thing you can do is wait to find out if your body killed off the virus or not.  You need to make sure that you have a test with a very sensitive PCR result but if you have tested pos twice since 1997 it sounds like you do indeed have the virus. I doubt it could be THAT low a number that it couldn't register but it's possible.

It will take about 7 - 10 days for you to get the PCR results.

Any doctor (especially a blood doc perhaps) could order the basic tests (CBC, liver panel and PCR) to figure out what is going on.  I wouldn't really want to wait longer but you've waited a very long time already a couple weeks isn't going to make any big difference NOW.

[2hep2it]

Thanks for the response. My Lft's are still more than twice elevated ast, alt, and ggt as of this month. The article I pasted was from the Quest website...and its fairly recent. The date on it says current as of 2004 (and the copyright is 04-06 . The hemotologist appt is tomorrow (5/24/06) and the hepatologist (my first ever)is June 19th. My partner has chronic Hep B. So its more important than ever to get this resolved.If either of us ever needs the other to donate..we're pretty much screwed.I'm going to see a very well researched specialist. I'm reading her book now to get aquainted with her views ahead of time. I've been doing nothing but research...and there is a lot that is not being said about hepatitis ( in all its forms). I am not stopping untill I get to the bottom of this.

Best wishes

2hep2it

[2hep2it]

Frustratiing is the least of it. I have pain on top of more pain. And to boot there may be something wrong bloodwise. Thats why I'm seeing the hemotoligist. I've tested positive twice with a low of 5.0. I've never been tested for genotype...maybe because they are reluctant to say I have or have had Hep C. That is as they say "the rub". At this point all I get is " You may have a type that we don't know about yet". There are still other heps that they are reluctant to say conclusively cause or don't cause liver damage. I've been tested by 4 GI's and other PCPs, Cocnclusion since '97; Helicobacter Pylori, IBS, Strep, Shingles (2 times) and thalessemia. Which is why I'm seeing a hemotologist, since ,y nuetrophils have been in the 1400's since 97 ( or before). But no one will give me a definitive answer as to my liver status.Go figure. All of my test for HIV have been negative.  

So now I'm really going all out with it. It's making my job sufer a bit, since I can't sleep at night, and I have to take off when I'm really ill, and doctors appointments. SoO yeah..its getting  too be a bit much. Thanks for hearing me out.

2hep2it

[jmjm530]

The Quest website can be very confusing. Do you happen to have a link to the exact page you are referring to? Maybe someone can help shine some light on the matter. If not, ask your current or one of your new doctors and please let us know. You could also try Quest customer service although first-line support usually doesn't know very much and deepr support I assume is reserved for medical professionals.

-- Jim

[2hep2it]

Jim: Here's the link; http://www.questdiagnostics.com/hcp/intguide/jsp/showintguidepage.jsp?fn=TH_HCV_RNA_QualPCR.htm

Kalio: Yes, I have a lot of symptoms, itching,RQU,bone pain, fatigue, abdominal problems, headaches,chills,nightsweats every once in a while. But whats bothering me the most is the pain, and not being able to sleep at night. And the fact that my Lft's have not stabilized ever in the last 9 years....maybe more. You'd think that someone would have said yes, you do or not you don't have hep c. At this point , like I said they just don't know or are unwilling to find out. I'm becoming a pit bull. I was never complacent to begin with but its beyond tenacious now. Its a good thing I have copies of all of my bloodwork and tests since 97. The most important ones at any rate.

[jmjm530]

The test you're taking appears not to be a genotype test but a qualitative PCR viral load test with a sensitivity of 50 IU/ml.

In other words, if you have under 50 IU/ml, you get a "negative" result (probably don't have virus) and if you're over 50 IU/ml, you get a "positive" result, means you have hepatitis c. Did you get your results back yet?

It appears that this particular viral load test for some reason is only proven for geno's 1, so I'm assuming you previously had a genotype test that showed you were genotype 1?

If so, then the test seems OK, although I could see many doctors picking another test for screening someone off treatment.

If you're going to get another test, why not ask for Quest's Heptimax. It combines a quantitative PCR with a quantitative TMA, so you get both a numeric score as well as sensitivity down to 5 IU/ml. It's also used for all genotypes as I understand it.

Hope this is helpful.

-- Jim

[jmjm530]

I understand your frustration. But if it helps any, the odds are you are a geno 1 (most in America are) and if so, then a negative on the test you mentioned means you don't have Hepatitis C. Let's hope this is how it pans out. Let us know what you find out with your new doctor.

-- Jim

[can-do-man]

amertracy, You doing ok today kid?

lilmoma, how you doing lilmoma. BTW, i know how old you are. HAHAHAHA

[amirtracy]

hi! yeah. i'm doing pretty good today. knock on wood...how 'bout you? ya know i'm always thinking about ya and wishing the best your way.

[2hep2it]

Thanks Jim.

That was my point exactly...why give me a test only good for a specific genotype? and no....I was never tested for genotype in the past (not even when I tested positive twice). What if I have any of the other types such as 2 or 3 etc? Doctors can't live with them...er...wrong  phrase.lol.

I was thinking about the heptimax. I'm going to bring up a lot of things when I see the hepatologist in June.

2hep2it

[jmjm530]

Ok. Read your post again. Appears that you did test negative on the test you referenced. So, if you're a geno 1 a or 1b, you most probably do not have the virus. I'm sure you were genotyped at some point in the past, so if you don't know, ask your doctor. If it turns out you are not a geno 1, then maybe request another test like Heptimax to play it safe.

Regarding your different test results -- maybe your first test was simply an antibody test which doesn't tell the whole story? BTW could not find your original post "need help with.." because it probably got buried in another thread -- therefore just working off what you said here. All the best luck.

-- jim

[2hep2it]

Thanks Jim,
But its also  probable that I have another genotype. So its not all clear and pat. There are people...even on here that have genotype other than 1 ( such as 2 or 3 ).Which is good because they are easier to "cure". At this point though all I know is that something is still seriously wrong. I will keep you posted.


2hep2it

[jmjm530]

You're right. Even though most of us are geno 1's, a lot still have other genotypes. If it starts weighing on you before your appointment -- depending on your insurance and such -- you might be able to convince your primary to run a Heptimax test from Quest Diagnostic prior to your upcoming appointment. Heptimax covers pretty much the entire range of viral load and all genotypes.

All the best with your upcoming appointment and hopefully you'll start feel better soon. Please keep us posted.

-- Jim

[jmjm530]

I'd take things one step at a time. First, find out if you really have the virus or not using the standard tests. "Occult" virus is a whole other topic with many opinions. Personally, I wouldn't lose any sleep over it, but if you want to entertain more of a discussion, you might flag someone with the screename Double Dose as well as bring the article to the new hepatologist you'll be seeing.  But as I said before, first deal with whether or not you have any detectible virus by getting an appropriate viral load test.

-- Jim

[2hep2it]

I finally found something concrete that might help me when I go to see my specialist next month. This has been what I've been telling my partner all along. Its a shame that doctors don't tell you anything to help. All I ever got was  " maybe you have a hep virus that we don't know about yet". The fact that I tested positive twice notwithstanding.Check this out and tell me what you think.

http://www.medicalnewstoday.com/medicalnews.php?newsid=5130

[commanderinchief]

Hi everyone.

Just started my first week last friday and immediately started feeling the side effects. After reading these postings, I am beginning to believe I may not be as prepared for this as well as I thought.

I'm feeling very out of it lately and can feel the stress on my heart. I figured there would be sx but not so many. Haven't read anything yet about hair loss? I probably won't get that one. No. Not bald. I actually have plenty to spare.

I'm also going through this ordeal alone. I have a room mate but he knows nothing as far as I know but he's also a computer tech at the very Health Insurance carrier I have. He's a total ass and has every other phobia you can think of. I'm in the process of changing this but I also had bi-lateral knee surgery on May, 06. (No. My knees don't go both ways now...lol)

Anyway. Good luck all you good people. I hope your last bad day is the worse it will ever get. I'm looking forward to hopefully get to know some of you. I'm accessible @ ***@****

Keep on Truckin'