HCV RNA not detected

[punkiling]

I have research this and still do not understand it.  I have been treating HepC since March 2009.  At that time my count was 14 million.  3 months later, it was 185.  Just tested last week at it was <43, less than 43.  My doctor said last month if the count was not zero, he would stop treatment.  I go see him tomorrow but asked the lab for my results before I go so I could learn a little more before seeing him.  If my count is now <43, and beneath that is states "HCV RNA not detected" doesn't that mean that the <43 is just as good as a zero?  I do not want to stop the meds.   I suffer from every side effect known and some that man isn't even aware of yet, but if continuing with the meds will do what they are suppose to do, shouldn't I demand that I stay of them if the doctor says to stop.

I have truly learned a lot from this site and have even been able to help others.

[JennyPenny]

If you are a genotype 1 you need to complete 1 year of treatment. If you are genotype 2 or 3, you can probably stop now.

[can-do-man]

Sounds like your at week 24 ? Your odds would be very low if not und at week 24 and most doctors would stop tx. Even if you are und extending might be of help.

Maybe time to step back and talk with your Doc about your SVR odds and the new PIs in trial. Your response sounds alot like mine on my first tx........... Good luck

Can

[GreatBird]

HCV RNA not detected *is* the goal. It looks like the test your doctor is ordering for you does not quantify below 43 IU. You would never be 0. There is no test that goes that low. What kind of doctor are you seeing?

[neptune235]

Think of the report as being two pieces of info: a quantitative part with a lower detection limit of 43, and then a seperate qualitive test, whic is MORE sensitive than the quantitative part of the test, but only reports a pos/neg result.

You are testing negative for both parts, which is most certainly the goal.

If I were in your sitch, I'd be asking the doctor how long to continue treatment now that you are virus free.  I would expect a number close to 48 weeks.

[CoWriter]

It means the test can measure down to 43....so <43 means undetectable.

However, the fact that you had virus at week 12 and cleared by week 24 makes you a "slow responder" and you need to extend treatment to 72 weeks.

Co  

[newleaf09]

Your particular PCR test cannot detect below 43 virus particles.  It's a CYA way to say they are not finding any virus, but oh, by the way, if there were 42 virus particles their test might not be able to see that.  It means negative, no virus found by their test.

Some doctors follow the guideline that if you are not undetectable by 12 weeks, you are only a partial responder to interferon therapy and may not be able to clear the virus permanently on the current therapy option (peg/riba), so why put you through a year of misery for nothing.  Not all doctors feel that way, though.  Some consider that you have 24 weeks to prove that your body can respond to the therapy.  Have a longer talk with the doctor (not the nurse) and see if you can come to an agreement on what to do next.

[nygirl7]

Yes as it said above if you were not clear at 12 and responded so slowly you are now looking at extending till 72 weeks (like many of us have) in order to get the advantage back onto your side...and even then the odds are less then for someone who did make it.

If you don't extend the odds are less than 1% or something extremely low - not sure of the number exactly but it's that low.

your doctor can do a more sensitive test that goes down to <2 or <5 so you can be more relatively sure that you are UND...but UND is UND and no other substitute counts.  IN the olden days wheN I first started here the best test only went to <615  lots of people were really NOT UND that thought they were.  When it was my turn the test was the next test down bjut I had a count of 411 - if I had taken the 615 test I would have believed I was UND when in reality I certainly was not.

See why it's so important?  I extended to 72 because I was not "UND" until week 24 test which was <5 so I was pretty sure I really was........but if I had never known that I was not UND I would have only tx'd till week 48 and might not be cured today.

[GreatBird]

The tests I've been getting have been able to tell whether there is virus present but unable to be quantified under the threshhold (which in my case has been 25, in this case it's 43). So, a result that says NOT DETECTED under 43 could mean (depending on which test this is) that not only could they not count it, but couldn't find it. At all.

[Marcia2202]

I think what you are saying with 0 is undetected.

So far you still have not reached an undetected status. Your doctor will pull you off treatment if you are not undetected by 24 weeks.

Even if you were undetected by this time, it would not be advisable to treat for 48 weeks. You would actually need to treat for 72 weeks to have a better chance of clearing the virus.

Personally, I would stop treatment and treat with the PI drugs, when they come out 2010 / 2011.