Lab question

[newbie2015]

I was diagnosed 2012 hep c. My viral load last year was almost 9 mil. This year 3 mil. My lab report is different though in that it states this and I want to know what this means
\
4/2015                         See Comment

Result HCV detected viral load 2.7 mil log 6.43

Reference range: No HCV RNA detected

HCV RNA Interp A SEE COMMENT       HCV - p           Not Detected

So my question is what is this comment and not detected about? Thank you

[newbie2015]

Thank you for all comments very helpful thank you.  

[SurfsideGal]

Don't get hung up on the healthy range, or normal range. What Jimmy told you is absolutely correct. Either you have a detected viral load and are hep C infected or you do not have a viral load and are undetected which means you do not have the virus.

If someone is unhealthy and dying from hepatitis C, they can be detected. Or they can be undetected because the virus is gone, but the damage was so severe they need a liver transplant or they have hepatocellular carcinoma which is a risk for cirrhotic patients who are undetected although a lower risk than if they still had the virus.

[JimmyMose]

Because if you do (are detected or number shown)then you have the active virus.

[JimmyMose]

Reference range is the normal range.  Most blood tests will show High if above and Low if below.  Because your supposed to have a certain range of the of it in your blood.   For HCV you either have the active virus in your blood or you don't.   the normal range for HCV RNA is undetected because if you do then you have the active virus.

[newbie2015]

So what does that mean Hope? I have never had this on my test before and so if I was unhealthy and the hep c was killing me would the reference range not show "detected"??  Please clarify what you mean healthy people reference range"NOT detected"? Thank you. This is exactly what is confusing. And no one can explain. Thank you again.

[SurfsideGal]

"HCV RNA Interp A SEE COMMENT       HCV - p           Not Detected

I think it was this comment that is confusing, at least to me. I have never seen that on an HCV/RNA lab result.

[HopeInPA]

Hi  newbie! "reference range" section on the blood test shows what is normal. Like when they test hemoglobin, next to the number  they print the reference range for normal people of your age group. In HCV RNA test the normal 'reference range' for healthy people 'NOT Detected'. That's all there is to it.

So your test shows that you have 3 mil viral load and normal 'reference range' for this type of test is 'not detected'.

[dontworry_behappy1]

That's great.  Let us know the results.  : )

[newbie2015]

I have the viral load test that is the one I posted. I am getting blood test to determine liver damage instead of the biopsy :)) Thanks

[dontworry_behappy1]

Sorry got you mixed up with the person with MS.  You do need to ask the
questions.  Forget the one about MS.  

[SurfsideGal]

They obviously believe you have a viral load if they are ordering Harvoni. Let's hope the new test results will be easy for you to understand so you have a definitive answer. Hang in there. I know you must be frustrated.

[dontworry_behappy1]

Could find any current questions on medhelp.   But will give you some question for your doctor.  If you have a viral load.

1.  What is my genotype
2.  When can I get a shot for Hepatitis A&B?  You you haven't got one yet.
3.  What is the current condition of my liver?  When will I find out?
4.  Can I treat while on my MS medication.
5.  How long does will it take before I can start treatment.

You will have to know your genotype and the current condition of your liver
before you can start Hepatitis C treatment.

Hope this is helpful… Let us know the results.

[newbie2015]

I have no idea, that was exactly my questions, but no one seems to want to answer, but they are ready to send the harvoni. I have never had a test like this. I have had plenty tests since diagnosed but never like this.

[dontworry_behappy1]

Wait for the viral load test.  HCV RNA (viral load test) will confirm if you do
or do not have hepatitis C.  If you have a viral load….you have hepatitis C.
If you don't have a viral load….you don't have hepatitis c.  

You will get the results on Tuesday?  Thats great.  At least you will know
for sure.  Ask for a copy of the test results.  If you have a viral load you
want to ask what your "Genotype" is.

Let me see if I can get you a link to questions to ask your doctor.

[SurfsideGal]

Newbie, her comment still concerns me. IF you ever had hep C, even if your viral load was negative, and you were screened, it would show up. Once you are antibody positive, you are that way for life, even if you get to undetected. I think there are too many questions that need to be answered. If she wants to treat you, they must believe you are viral load detected. So how can anyone say it wouldn't show in a screening? It is even hard to write about this because they have made it so confusing. My confidence in this group would be destroyed. Can you get a second opinion?

[newbie2015]

She meant if I was just being screened for Hep c it would not show up so I am assuming the antibody test.  And yes the 2nd one meant that she would like to get me cured as they all say but I would think as well it would be detected within reference range as well. Anyway my first few tests were done at quest this one was TMF in southbend indiana. Thanks for input.

[SurfsideGal]

Wow, that is so confusing Newbie. I doubt your doctors and nurses are being dishonest purposely. I think they are confused as well. Which laboratory did your viral load? Was it Quest or LabCorps or another lab?

The fact that your viral load has bounced around is not unusual at all. That is a common finding in hep C patients. As for the comments the nurse made"if they do a normal blood test they wouldn't find the virus, is very odd and difficult to tell what she meant. The nurse that said she was going to get you to the level of the comment, likely means her hope for you is to treat and get to undetected.

What do you mean by a "regular" blood test? The only way to find hep C in the blood is to do an antibody test and a viral load test. Above 43 in the Cobas PCR test is definitely detected.

I will say that in all my years in the hep C community, I have never seen a viral load report formulated like yours. Your lab likely has a customer service department and if you don't get this figured out you might try to call them.

[newbie2015]

Thank you for your response. I seem to be getting conflicting statements from my doctors office and that is the reasoning for my ? My first doctors nurse said she has never in 20 years seen anyones tests do what mine have. I have been treating naturally btw.  She also said that if they did a normal blood test that what that meant was that they would not detect the virus.
Then the new doctor that I had this time - his nurse acted like it was nothing out of the ordinary. - and she stated that the comment was the level she was going to get me to??  So I am just having the feeling that someone is not interpreting things to me honestly.
The first nurse told me I might want to get in a study so that these doctors can see what my body is made of.  My cholesterol is 154 my triglycerides are 71 my liver tests have always been normal and my kidney functions are as well great.
What I am confused about i guess is how if my viral load is 9 mil or 2.7 mil could they do a regular blood test for hep c and not find it? Does that make any sense>>? If it above the 43 cutoff why would it not be detected? Thank you in advance for any light you might shine on this.  

[dontworry_behappy1]

Your 2012 viral load was 9 million and this year its 3 million.  Viral loads go
up and down.   9 million to 3 million is a big difference in a viral load.  

Results HCV detected viral load 2.7 mil log 6.43.  Means you have Hepatitis C.  That your viral load is 2.7 million.  Log is just is a different way of measuring and 2.7mil and log 6.43 mean the same thing.

Reference range. No HCR RNA detected.   This means if there is not viral
load then its not detected.  In your case it was detected.

HCV RNA interp A SEE COMMENT HCV- HCV-p  Not Detected.  I'm not sure about this last one.  

Regardless, you do have a viral load and therefore you do have active Hepatits C.