Aa
Lab Corp no longer offering <10 PCR.
Scared the c**p outa me for sure. As most of you know I dropped the RIBA a few weeks ago. Well I did a PCR, checking on break thru. When I called my lab lady she read the results saying "<43" HCV RNA not detected." I'm LIKE, what's this <43?? She doesn't know, she said it was the same test we've been doing from the start which is the 10 to 100,000,000 . (been UND <10 from week 2) Of course I'm thinking of the confusion during the Telaprivir trials and others. Well I'm a LITTLE worried at this point so she starts making calls trying to find something out. That was yesterday, got the word this morn. Lab Crop has stopped the 10-100,000,000 and in it's place is using a 43-69,000,000. The L.Corp lady told my lady that they considered this test more reliable and consistant. I am still UND. jerry
Yes, I know. I had a PCR done today at Quest because LabCorp stopped doing the <10 TMA.
The phlebotomist at Quest said your lab requisition has an order for a PCR quant and Heptimax. I have to order both. I said the Heptimax on the order is telling you what kind of test to order. Heptimax does qual & quant. She said sorry, I've got to order both. We went round and round and it got loud and she called customer service. They said just order the Heptimax, not need for a separate quant. @#*&%#$#
We shouldn't have to go through this. Infuriates me.
The phlebotomist at Quest said your lab requisition has an order for a PCR quant and Heptimax. I have to order both. I said the Heptimax on the order is telling you what kind of test to order. Heptimax does qual & quant. She said sorry, I've got to order both. We went round and round and it got loud and she called customer service. They said just order the Heptimax, not need for a separate quant. @#*&%#$#
We shouldn't have to go through this. Infuriates me.
wow, that would have had me worried.
You would think LabCorp could at least have added a note to the lab report stating the change in requested to available tests.
Dont like the less sensitivity, but if it is more accurate suppose that is a good thing.
apache
You would think LabCorp could at least have added a note to the lab report stating the change in requested to available tests.
Dont like the less sensitivity, but if it is more accurate suppose that is a good thing.
apache
They're idiots. LOL. BTW just to add to the confusion, if you call up cust service (or ask for an interim report) they will tell only call Heptimax the second part of the test (below 50) and refer to the first part as a real-time PCR. Still, the reporting of Heptimax is far less confusing than the LabCorp reporting IMO. Just keep in mind that Heptimax is two separate tests. A quant real-time PCR that goes down to 50 IU/ml. And a quant tma that goes down to 5 IU/ml. They only run the second test (the tma) if the first shows UND. For that reason, the longer it takes to get your results back the better. If you want an indication sooner, the real-time PCR is usually ready in 2-3 days although they sometimes stubbornly tell you that the results aren't ready yet. At that point, you have to tell them to give you the Real Time PCR results (not the Heptimax) results. LOL. Wonder who organizes these things. Good luck with the test!
-- Jim
-- Jim
Did you ask if LabCorp still offers the NGI Quantasure. This is a dfifernt test from the Quantasure PLus (limit 10) NGI Quantasure goes down to 2 IU/ml, if I remember correctly.
In the beginning of treatment everyone should get a <2 anyway to find out the viability of their UND. With so many docs now realizing how important that 4 week result is - I totally believe if you can get your doc to go for it get it.
It is worth asking for.
It is worth asking for.
Did they express the results in "IU's" or 'Copies"?
This is a great question for HR to wade in.
Perhaps the lower limit (43) is expressed as copie, not IU's. Various tests report in International Units but the various tests use varying converstion factors to determine how many 'copies' are in an 'International Unit'. In the past, I think HR estimated that it was 2.5, but I think he was referring to an average and not a particular test. If he was referring to a prticular test, it was probably the NGI.
This is a great question for HR to wade in.
Perhaps the lower limit (43) is expressed as copie, not IU's. Various tests report in International Units but the various tests use varying converstion factors to determine how many 'copies' are in an 'International Unit'. In the past, I think HR estimated that it was 2.5, but I think he was referring to an average and not a particular test. If he was referring to a prticular test, it was probably the NGI.
Yes, iirr from previous HR post, 2.5 virons per 1 IU/ml
Don't think it matters what test.
For every 1 IU/ml of virus in blood = 2.5 virons
apache
Don't think it matters what test.
For every 1 IU/ml of virus in blood = 2.5 virons
apache
Actually, the conversions are not the same for all types of tests as FLGuy said. For that reason, it's surprising that some labs still report in copies and haven't simply converted to IU/ml. Between "copies", IU/ml and "logs" -- test results now can be misinterpreted three different ways.
LabCorp have moved from the Abbott test to Roches Taqman test.
Funny thing is Taqman is supposed to reflex down to <15 when Und @<43.
I wouldnt worry about it though, if you breakthru it will be a lot higher than 43
I dont agree with LabCorps assessment that Taqman is superior tp the Abbott test.
Me thinks Roche have done a deal.
The 43 is in IUs and the conversion to copies is either 2.5 or 2.7 I cant remember which.
CS
Funny thing is Taqman is supposed to reflex down to <15 when Und @<43.
I wouldnt worry about it though, if you breakthru it will be a lot higher than 43
I dont agree with LabCorps assessment that Taqman is superior tp the Abbott test.
Me thinks Roche have done a deal.
The 43 is in IUs and the conversion to copies is either 2.5 or 2.7 I cant remember which.
CS
Thanks for that info about not offering the <10 test anymore. I had the same thing happen to me. I was did the LC <10 test at week 3 ,8,12,and all were UNDE <10. then at 16 weeks I call for results and I liked to $h%& when she told me <43. It still said at bottom "unable to measure because no virus present". But that didn't help my heart stopping when she told me <43 at first !!!
We figured they made a mistake and ran the wrong test. From now on I will order the NGI quant <2
We figured they made a mistake and ran the wrong test. From now on I will order the NGI quant <2
I am a little confused as to what test to get. Is it just Lab Corp doing that or Quest also?
Copyman what is NGI
Copyman what is NGI
Cant help you with Quest.
NGI = National Genetics Institute.
They are part of Labcorp and have PCR tests that go down to <2IU.
But you need to order them with the right LabCorp code.
CS
NGI = National Genetics Institute.
They are part of Labcorp and have PCR tests that go down to <2IU.
But you need to order them with the right LabCorp code.
CS
I didn't think to ask 'bout the NGI. I did one of those at 6 weeks. It took alot longer to get back, (was told it had to go to Ca.) and was about twice the $$ sparrow- yeah I know, but it was still a real stomach twister not knowing what was up! (except my #s, 10 to 43).'BOUT HAD TO CHANGE MY PANTIES!! JERRY
MEDICAL PROFESSIONAL
Copies equals virions. The international unit is an artificial "unit' that measures something that can be counted, by an abstract standard that is mostly interpreted here as meaning virions - it does not, there is a factor of 2.5 in between. Not enough time to explain why all that came about, but most Hepatologists dislike the iU.
How many people are in the room? 100 international people units. (But the head count was 250).
The Labcorp code for the NGI Quantasure is LC 140639.
One you are UND you might as well use the cheaper HCV NGI Ultraqual,
LC code 140609, it has the same sensitivity. thus if you are UND, you are very UND....
Why does the NGI test take so long: Because it uses a much much more elaborate procedure. There is no way around that to achieve that kind of extreme sensitivity.
The usefulness of a more sensitive test for UND has been discussed here at length. As long as the Vl is still high, there is no need for this test.
How many people are in the room? 100 international people units. (But the head count was 250).
The Labcorp code for the NGI Quantasure is LC 140639.
One you are UND you might as well use the cheaper HCV NGI Ultraqual,
LC code 140609, it has the same sensitivity. thus if you are UND, you are very UND....
Why does the NGI test take so long: Because it uses a much much more elaborate procedure. There is no way around that to achieve that kind of extreme sensitivity.
The usefulness of a more sensitive test for UND has been discussed here at length. As long as the Vl is still high, there is no need for this test.
HR - Copies equals virions.
Is that strickly true.
bDNA and TMA have a conversion factor of 5.2 or something.
So what are they counting. It cant be the same virons as the ones your tests are counting.
Roches Amplicore tests have a conversion factor of 2.5
and Taqman iss either 2.5 or 2.7.
Doesnt the Abbott test (10-100,000,000) have a different conversion factor.
I really dont understand how the different tests can count virons differently.
CS
Is that strickly true.
bDNA and TMA have a conversion factor of 5.2 or something.
So what are they counting. It cant be the same virons as the ones your tests are counting.
Roches Amplicore tests have a conversion factor of 2.5
and Taqman iss either 2.5 or 2.7.
Doesnt the Abbott test (10-100,000,000) have a different conversion factor.
I really dont understand how the different tests can count virons differently.
CS
CS
"I really dont understand how the different tests can count virons differently."
Ya, me too CS. Are you sure of the 5.2 factor for TMA ?
Well if iU/ML is a international unit it should always consist of approximately 2.5 virions. Hey what good is 1mm if it equals .0040" in the USA and .0060" in England
Best i can understand is most commercial automated tests cant count individual virions accurately so they kind of cheat and use small groups ( iU ) to make there count.
So to rehash... .4 iU/ml or 1 handle less vacuum remnant that the lame dog/wolf mutants shed all over a hidden compartment have very little significance in the world of HCV
"I really dont understand how the different tests can count virons differently."
Ya, me too CS. Are you sure of the 5.2 factor for TMA ?
Well if iU/ML is a international unit it should always consist of approximately 2.5 virions. Hey what good is 1mm if it equals .0040" in the USA and .0060" in England
Best i can understand is most commercial automated tests cant count individual virions accurately so they kind of cheat and use small groups ( iU ) to make there count.
So to rehash... .4 iU/ml or 1 handle less vacuum remnant that the lame dog/wolf mutants shed all over a hidden compartment have very little significance in the world of HCV
Amplicor HCV Monitor v2.0 ............. 1 IU/mL=0.9 copies/mL
Cobas Amplicor HCV Monitor v2.0 ... 1 IU/mL=2.7 copies/mL
Versant HCV RNA 3.0 Quantitative ... 1 IU/mL=5.2 copies/mL
Cx HCV RNA Quantitative ............... 1 IU/mL=3.8 copies/mL
SuperQuant ..................................... 1 IU/mL=3.4 copies/m
Source: http://74.125.47.132/search?q=cache:AHEx6Ups8KgJ:www.hcvadvocate.org/hepatitis/Basics/Viralload_2008.pdf+international+units+hcv&hl=en&ct=clnk&cd=3&gl=us
Cobas Amplicor HCV Monitor v2.0 ... 1 IU/mL=2.7 copies/mL
Versant HCV RNA 3.0 Quantitative ... 1 IU/mL=5.2 copies/mL
Cx HCV RNA Quantitative ............... 1 IU/mL=3.8 copies/mL
SuperQuant ..................................... 1 IU/mL=3.4 copies/m
Source: http://74.125.47.132/search?q=cache:AHEx6Ups8KgJ:www.hcvadvocate.org/hepatitis/Basics/Viralload_2008.pdf+international+units+hcv&hl=en&ct=clnk&cd=3&gl=us
From a 2000 paper making the argument for IU/ml versus Copies, as it suggests that a "copy" is not always a "copy" depending on the test used:
"...Indeed, in the absence of standardized HCV RNA quantification units, 1 copy/mL in
Monitor, 1 genome equivalent (Eq)/mL in Quantiplex, and 1
copy/mL in Superquant do not represent the same amount of
HCV RNA in a clinical sample, these units having been defined
independently, with quantified standards of different
natures, lengths, and sequences. In addition, the same units
can also vary from one version of a commercial assay to the
next.16 Thus, 2,000,000 or 3,500,000 copies/mL in Superquant
may not be 2,000,000 or 3,500,000 copies or Eq/mL in
assays other than Superquant, meaning that these assays cannot
be used to tailor the duration of combined treatment unless
the exact correspondence between the various units has
been established.17
To permit universal standardization of HCV RNA quantification..."
Source: http://www3.interscience.wiley.com/cgi-bin/fulltext/106596948/PDFSTART
"...Indeed, in the absence of standardized HCV RNA quantification units, 1 copy/mL in
Monitor, 1 genome equivalent (Eq)/mL in Quantiplex, and 1
copy/mL in Superquant do not represent the same amount of
HCV RNA in a clinical sample, these units having been defined
independently, with quantified standards of different
natures, lengths, and sequences. In addition, the same units
can also vary from one version of a commercial assay to the
next.16 Thus, 2,000,000 or 3,500,000 copies/mL in Superquant
may not be 2,000,000 or 3,500,000 copies or Eq/mL in
assays other than Superquant, meaning that these assays cannot
be used to tailor the duration of combined treatment unless
the exact correspondence between the various units has
been established.17
To permit universal standardization of HCV RNA quantification..."
Source: http://www3.interscience.wiley.com/cgi-bin/fulltext/106596948/PDFSTART
MEDICAL PROFESSIONAL
Well I just wrote a 3 page explanation, why "robust single copy PCR" using electrophoresis and Southern blotting after the amplification combined with limiting dilution techniques does allow to quantify a standard in absolute terms of "copies". Sadly this very detailed account was lost when submitting it. Thus I have to point to an earlier fairly detailed explanation of this aspect that I posted quite a while ago.
Very frustrating, that's happened to me more than once.
As a researcher I can understand why you might prefer "copies" to IU/ml in the type of test you just mentioned. But if I read you correctly, you're speaking to a specific testing protocol. However, the problem as I see it -- and I believe as stated in the paper -- is that there are so many different tests out there that some sort of standardization was necessary so patients and their doctors worldwide could share meaningful information and observe universal guidelines.
-- Jim
As a researcher I can understand why you might prefer "copies" to IU/ml in the type of test you just mentioned. But if I read you correctly, you're speaking to a specific testing protocol. However, the problem as I see it -- and I believe as stated in the paper -- is that there are so many different tests out there that some sort of standardization was necessary so patients and their doctors worldwide could share meaningful information and observe universal guidelines.
-- Jim
Apache1 - Are you sure of the 5.2 factor for TMA
Yeah.
from Journal of Hepatology
Hepatitis C minimal residual viremia (MRV) detected by TMA at the end of Peg-IFN plus ribavirin
The TMA assay has been validated to have a sensitivity of 5–10 IU/ml or 25–50 copies/ml
http://www.specialtylabs.com/education/download_PDF/TN_1193.pdf
Hepatitis C Virus RNA DetectR™ [TMA]: Detects presence of Hepatitis C Virus RNA down to 10 IU/mL, to diagnose Hepatitis C Virus infection.
(Note: 5.2 copies/mL = 1 IU/mL; Bayer Corporation 2001)
CS
Yeah.
from Journal of Hepatology
Hepatitis C minimal residual viremia (MRV) detected by TMA at the end of Peg-IFN plus ribavirin
The TMA assay has been validated to have a sensitivity of 5–10 IU/ml or 25–50 copies/ml
http://www.specialtylabs.com/education/download_PDF/TN_1193.pdf
Hepatitis C Virus RNA DetectR™ [TMA]: Detects presence of Hepatitis C Virus RNA down to 10 IU/mL, to diagnose Hepatitis C Virus infection.
(Note: 5.2 copies/mL = 1 IU/mL; Bayer Corporation 2001)
CS
The TMA assay has been validated to have a sensitivity of 5–10 IU/ml or 25–50 copies/ml
Actually that makes it 5 doesnt it
HR
Sorry you lost the Post, i would have been really interested in reading it.
The different way of counting a single viron has driven me nuts fior ages.
CS
Actually that makes it 5 doesnt it
HR
Sorry you lost the Post, i would have been really interested in reading it.
The different way of counting a single viron has driven me nuts fior ages.
CS
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