Next week test.....

Hey Guys,
     I hope that all are doing as well as possible.  Next week I will be having my VL test done.  What kind of test should I request that my Dr do when testing the VL?  I have heard many different types of test....some that are more sensitive than others?  What is the best test and what should I request?   May God bless you all way in always.......

In Christ,
Rick

[Myown]

My doc uses Heptimax goes down to 5iu. People here had advised me to get this test, but TG they do use Heptimax where I go, so no problem getting what I wanted.

[jmjm530]

FOR NOW...

Heptimax by Quest Diagnostics (or) HCV NGI Quantasure ( LC#140639)by Lab Corp.
Both tests are highly sensitive, so use whatever is most convenient and covered by your insurance.

FOR LATER...

Once you become non-detectible, then you can continue to use the above two tests, or switch to Quest's HCV RNA Qualitative TMA or LabCorp's HCV NGIs Ultralqual ( Labcorp#140609).

I copied the LabCorp numbers from one of HR's recent posts so I'm sure he'll correct me if I'm wrong in some aspect.

All the best luck,

-- Jim

[Myown]

Once you become non-detectible, then you can continue to use the above two tests, or switch to Quest's HCV RNA Qualitative TMA or LabCorp's HCV NGIs Ultralqual ( Labcorp#140609).

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hi Jim,

I just don't get it with the difference between tests. Can you break it down. I just don't seem to get it when I read TMA and such. I get lost.

Thanks

[jmjm530]

Here's how it works with the two Quest tests I mentioned in a simplified manner.

Heptimax is a QUANTITATIVE test. That means it quantifies the virus giving you a numerical result. For example, some typical results might be 1.5 million IU/ml, 485,00 IU/ml or 200 IU/ml. The range of the quantification is all the way in the millions down to 5 IU/ml. If you have less than 5 IU/ml, then Heptimax will report your results as "<5 IU/ml". This is the same as non-detectible.

The second Quest test is their HCV RNA Qualitative TMA. It is qualitative, not quantitative. That means this test will not give you a number. It will either tell you that you are detectible or not detectible to the sensitivity of the test, which like Heptimax is 5 IU/ml. So, using one of the examples above, if your actual quantification was 1.5 IU/ml, this test would simply report it as "Virus Detected". No numbers would be given. Conversly, if your actual quantification was below 5 IU/ml, then this test would report it as "Virus Not Detected".

So, why two tests and which one to use and when?

Why two tests? Actually there are more than two tests so it's like asking why ten brands of toothpaste. There just are.

Which one to use and when? You can use Heptimax before, during and after treatment. It was designed as a one test for all circumstances, so if you find this confusing, just tell your doctor to order Heptimax and you'll be fine.

I didn't find out about Heptimax until my second week of treatment and then used it all during treatment and up until around six weeks post treatment. At that point I decided to switch to Quest's HCV RNA Qualitative TMA. Didn't have to but decided to for a couple of subjective reasons. The bottom line, however, was that post treatment I didn't need to know the quantity of virus, I just wanted to know if I was detectible or not.

Another way of looking at it is that if you're either very sure you have no virus via a quantiative test or if the only thing you want to kmow is whether you're detectible or not -- than you can use a qualitative test. However, if you want to know the quantity of the virus, then you use a quantitative test. For this reason quantitative tests are generally used pre-treatment and during treatment until someone becomes non-detectible. At that point, you can either continue using a sensitive quantitative like Heptimax or switch over to a sensitive qualitative like their Qualitative TMA.

Regarding LabCorp's two tests. Simply substitute their Quantasure test for Heptimax and their UltraQual test for Quest's Qualitative TMA and you'll get the general sense.

Hope this helps.

-- Jim

[Myown]

great explanation! now i understand.

appreciate it!

[nygirl7]

My doctor would only give a regular PCR - it wasn't until later after being UND that I was able to get a TMA because I needed it to be so sensitive. In the beginning he just wouldn't do it.

I wish I could have had one all along but if you can't - at the end is the most important so you know it's not come back again I guess.

In other words - don't freak out if they refuse to give you that sensitive a test in thet beginning...they can be a pain.

[jmjm530]

Actually, the most important time to get the sensitive test is early-on in treatment when you're trying to determine if you're actually non-detectible or not. They gave me the usual not very sensitive (615 IU/ml) Bdna at week 2 but I wish I was given a more sensitive test. My result was <615 so I really have no idea whether or not I was non-detectible at that point.