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Heptimax
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Heptimax

Is it necessary to have Heptimax on the prescription when running a viral load at any lab other than Quest?
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1669790_tn?1333666195
There are several tests available and each lab has their own proprietary test.  Each test as a limit of detection (LOD) and a limit of quantification (LOQ) in which they can count the virons in the sample.  In your case it sounds like the LOD is 7 IU/ml as your PCP stated and the LOQ is 43.  It doesn't sound like your trial doctor wants to switch the pcr thats been subscribed and I don't think you need to worry at this point about using the more sensitive test.  The difference between detecting 7 IU/ml and 2 IU/ml in the most sensitive test available is debatable considering the extra cost and time for results.  

In case you're interested, following is a summary of the PCR's that are currently available.  I believe this list is correct and current.  If not, anyone  feel free to correct or update.  

Each of the tests have a limit of detection (LOD) and a limit of quantification (LOQ).

1.   Labcorp NGI QuantaSure: (LOD) 2 IU/mL and (LOQ) 2 IU/mL.

2.   Labcorp Quantitative RT-PCR: (LOD) 7.1 IU/mL and (LOQ) 25 IU/mL.

3.   Abbott RealTime PCR: (LOD) 12 IU/mL and (LOQ) 12 IU/mL.

4.  Quest RT-PCR: (LOD) 7.1 IU/mL and (LOQ) 43 IU/mL.

5.  Quest Quantitative TMA: (LOD) 5 IU/mL and (LOQ) 5 IU/mL.

The Quest Heptimax test is a two part rollover test using the RT-PCR test (#4) and if lower than 43 IU/mL, then moves on to the TMA test (#5).  You can just do the TMA test to save time and money.

To answer your original question, you need to have the exact code for the desired test.  The labs won't just switch to what you want unless they have approval with your doctors office first.  
7 Comments Post a Comment
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789911_tn?1368640383
Quest is the only one that does the heptimax test are they not?   I would be making sure it is labeled regardless with the right code number and name to be double double sure they send off for the right one.  Believe it or not some of the phlebotomists dont know much about it.    I had to have them look it up.  Good test by the way....  There are many VL tests and they are confusing to say the least.  
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766573_tn?1365170066
Do you mean, for example, could you walk into a LabCorp and have a Heptimax if you have the right forms (or codes)? I always thought certain diagnostic assays had their own patent. Heptimax usually has the ® after it - I will let someone else address what that means as far as Quest goes.

Here is a link on how CPT codes work.
http://patients.about.com/od/costsconsumerism/a/cptcodes.htm
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3242225_tn?1348340121
You ARE right, thank you.  I just had a blood draw yesterday because I wanted to know NOW, before I was notified today that I am undetectable by my study.  I didn't think I'd be told until week 24.  So anyway, the lab I went to yesterday is Health Networks and they don't do the heptimax, only quest does.  I think it's too late to change it, the Dr. is not willing to stop it and have me go to Quest instead.  I'm having it done by my PCP and he didn't know.  Great guy though. I spoke to Health Network just now and they told me even though their test goes down to 7 (Heptimax goes down to 5) they put 40 and I asked why since it does go to 7 why not put that. She said they cannot quantify it.  Well, now it sounds like she is playing "you are the dumb patient and I will just confuse you and make you go away" games with me.  
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3242225_tn?1348340121
You are right.  Health Network told me only Quest does Heptimax. Bummer.
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3242225_tn?1348340121
I wish I had known you were here.  I have been so nervous, anxious, a wreck all alone with this.  Now I am getting near the finish, whatever that will ultimately be.  By January I will know for sure.
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1669790_tn?1333666195
There are several tests available and each lab has their own proprietary test.  Each test as a limit of detection (LOD) and a limit of quantification (LOQ) in which they can count the virons in the sample.  In your case it sounds like the LOD is 7 IU/ml as your PCP stated and the LOQ is 43.  It doesn't sound like your trial doctor wants to switch the pcr thats been subscribed and I don't think you need to worry at this point about using the more sensitive test.  The difference between detecting 7 IU/ml and 2 IU/ml in the most sensitive test available is debatable considering the extra cost and time for results.  

In case you're interested, following is a summary of the PCR's that are currently available.  I believe this list is correct and current.  If not, anyone  feel free to correct or update.  

Each of the tests have a limit of detection (LOD) and a limit of quantification (LOQ).

1.   Labcorp NGI QuantaSure: (LOD) 2 IU/mL and (LOQ) 2 IU/mL.

2.   Labcorp Quantitative RT-PCR: (LOD) 7.1 IU/mL and (LOQ) 25 IU/mL.

3.   Abbott RealTime PCR: (LOD) 12 IU/mL and (LOQ) 12 IU/mL.

4.  Quest RT-PCR: (LOD) 7.1 IU/mL and (LOQ) 43 IU/mL.

5.  Quest Quantitative TMA: (LOD) 5 IU/mL and (LOQ) 5 IU/mL.

The Quest Heptimax test is a two part rollover test using the RT-PCR test (#4) and if lower than 43 IU/mL, then moves on to the TMA test (#5).  You can just do the TMA test to save time and money.

To answer your original question, you need to have the exact code for the desired test.  The labs won't just switch to what you want unless they have approval with your doctors office first.  
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3242225_tn?1348340121
Thank you flcyclist.  It turns out, I got my PCP to switch to Quest Heptimax so that's good.  All this happened before I put on my computer and there was an e-mail from study that I was UND at week 4 which was the last blood test.  So anyway, I'm going to do the heptimax too cause by the time I do it, it will be 9 weeks post treatment.  What is your status, treated or not, if so UND?  What treatment?  I am sorry if you have already answered this but I do not yet know how to move around in this community or in medhelp.
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