Post treatment lab test confusion

[jules173]

Hi.  I'm 14 weeks post treatment (24 weeks for geno 3a) negative at 12 weeks during treatment and negative at end of treatment.  Question, because I 'm confused. I did my 12 week post treat labs.  I don't remember seeing HCV RNA Qual TMA on my lab slip but the lab ran one and it came back detected.  My doctor had the lab re-run for Quant TMA.  It didn't detect a viral load.  Isn't the 12 week post treatment lab supposed to be a viral load?  The reason I"m so concerned is, my doctor thinks this is good news and will check for viral load in 3 months.  3 months is a long time when wondering if it's back since there was a postive test..  I'm even more scared now then before treatment.  Should I feel good about a positive test?  My liver fuctions test are all back in the normal range.  Talking to my doctor did not help me at all, it just made me feel more confused.   It's really hard not to worry.  I found out I had hep c in 1994 but this was my first treatment because liver damage progressed.  I want to trust the doctor but he's a general g.i. not a hep doctor.     Thanks Julie  

[dperry10]

One will show < .50 or less than some number ,( depending on which they did, it could be one down to < 5) .. ( QUATITATIVE )

but it they ran the 2nd test, (QUALITATIVE )and its und  then you are fine..   One has the words printed Not Detected, the other shows the levels less than the minimun that the test goes to.

Mine was that same way.. I felt that same frustration , but that was during treatment, they first did the one that shows less than levels, the other I made them redo, actually said Not Detected on it.

Don't be worried, you are fine.

Dana

[Douglas Dieterich, MD]

The positive test is probably a false positive one. I agree with you that I would do another quantitative TMA at 16 weeks, now that you are worried, but it sounds like you are OK. It is our practice to check TMA( < 5 IU) at 4 weeks, 12 weeks and 24 weeks after stopping and more often if there is an issue. DTD

[jules173]

Thank you doctor.  I specifically asked my doctor he said yes the Qualitive TMA does show active virus, but because the Quant TMA could not detect viral load it was good news.  I'm just having a hard time wrapping my mind around the "detected" on Qualitive TMA.  I thought if the teatment worked it be  "non-detected".  Sorry to be such a pain about this.   It's wierd, I wasn't this stressed before treatment.   I want to be hopeful but realistic about my chances of SVR.  Thanks again for your time.  I'm glad your here.  Julie

[mike716]

I hope the good Dr. Dieterich replies to your second post and relieves your anxiety, but he usually doesn't re-post to people here. I guess he's busy and figures one post per customer is enough.

In case he doesn't post again, what he appears to be saying in his first reply is that the quantitative test that gave a positive result was probably false, since the more sensitive qualitive test detected the virus. I don't know why he thinks it couldn't be the reverse, that the qualitative test gave a false negative and the quantitative test was true.

This whole incomprehensible mess of viral load tests, when to apply them, their results, and what they mean, seems to have been specially designed to drive us HCV-infected people mad with confusion and anxiety. You are not alone. Aside from Dr. Dieterich and perhaps a few others, hardly any of the MDs treating hepatitis C patients know when and how to use viral load tests and how to interpret them.

Let's face it, after thirty-odd years or more of neoliberal medicine, where the only thing that matters is the bottom line, the state of patient care and treatment in the U.S. (and in the countries that followed the U.S. model) is as low as the economy, and going down with it.

If you've got a lot of money, maybe you can still buy some complete and understandable information from an M.D.

However, if you want some real help, stick to patients. Put your questions to the regular Hepatitis C Forum. The honest, knowledgable people there will give you full, comprehensible, sympathetic answers.


Mike

[Marcia2202]

I personally think that the system that alerts Dr. D's email only reports the initial post to him and that is why he never answers a second comment on the same post. So, each time one wants to ask a question, one needs to make a new post.

Marcia

[jmjm530]

If the qualitative said "detected" then: (1) you either still have the virus: (2) the test was a false positive like Dr. Dieterich suggests it could be. Take his advice and get tested again to find out. BTW it's unclear from your post the relative sensitivites of the tests involved, and that may be a factor. When you re-test, use the most sensitive test available, such as "Heptimax" which goes down to 5 IU/ml. "Heptimax" happens to be a quantitative TMA, but an equally sensitive qualitative test such as Quest's "HCV RNA QUALITATIVE TMA" would be just as good. Both tests have a sensitivity of 5 IU/ml.

-- Jim

[jules173]

Thanks Jim.  I did check with the lab.  The Quest's HCV RNA Qualitative TMA is what came back "detected". I am a little suprised at myself. I'm usually a positive person.   I knew my chances when we made the decision to treat. I'm thinking of my family and what they went through also with me.  I wanted to give them some peace of mind as well as myself, because I'm not going to get it from my doctor.  Just going through the crazies the past couple of weeks since I got the news.   Thanks for your patience with me.  I just want to get this behind me, like we all do, and get on with life.   I know enough about myself that this will pass, and I'll go on just like I did before I treated.  I guess the emotional price goes up when we put our all in to this treatment, and it doesn't go the way we wanted it to go.  My heart goes out to all who deal with this disease, doctors included.  Thanks for being here Jim, I mean really thank you!.  I guess I better get comfortable up on the fence again, just the splinters hurt a little more this time.   Julie

[jmjm530]

Personally, I'd repeat Quest's HCV RNA Qualitative TMA again in a few weeks. That's the test I use. If you are a bit "belt and suspenders" you could run both Quest's Heptimax and Quest's HCV RNA Qualitative TMA from the same blood draw. If both show UND, you should be home free. Of course if one is UND and the other shows virus you will be back to where you are now :) In any event, I wouldn't worry too much until you re-test. Hopefully it will be a happy ending as with many here who were in a similar circumstance.

-- Jim

-- Jim