Really Confusing Lab Resuts

[Liverman]

O.K. I am cirrhotic but only MELD 7. Been on Sovaldi and 1200mg. Ribasphere daily for 16 weeks of a 24 week course of treatment because I can't do Interferon any more. Went undetectable at week two until my latest lab which showed an RT-PCR Quant of Detectable of <15, BUT an HCV RNA Qual of Undetectable. Aren't those two results mutually exclusive? Anyone else experience this seemingly contradictory situation? Thanks in advance. Still slugging away at this disease!

[adamben101]

Check with your doctor but I think this might just be a dumb way of saying it's NOT detected.  If the machine cannot go lower than 15 iu/ml, then it cannot say you have HCV lower than that level.  To me this is a good test which shows it's non-detectable in your blood.  

[HectorSF]

I would talk to your provider for guidance. I would assume this is a laboratory error. A retest should show you still undetectable. In the VALENCE study ONLY 1 in 250 persons ever experienced "On-treatment virologic failure" on this 24 week sofosbuvir + ribavirin treatment. Normally the only people that fail treatment do so after stopping treatment. They "relapse" meaning their viral load reappears.

I know at the UCSF Hepatitis Clinic where they are treating many patients they have seen some patients who have had conflicting lab results depending on where the labs were done. "Detectable but not quantifiable" at one lab while at another lab "undetectable". So I wouldn't worry too much about it but call your provider and get their input and possible retest instructions.
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Hepatitis C Virus (HCV) RNA Detection and Quantification by Real-Time Reverse Transcription-PCR (RT-PCR), Serum

Interpretation:

"A result of "<15 IU/mL (<1.18 log IU/mL)" indicates that HCV RNA is detected, but the HCV RNA level present cannot be quantified accurately below this lower limit of quantification of this assay. When clinically indicated, follow-up testing with this assay is recommended ..."

Best of luck with your treatment!
Hector

[flyinlynn]

this is the note at the bottom of my result
HCV RNA BY RT-PCR, QUANT

The quantitative range of the assay is 15 IU/mL to 100 million IU/mL
using COBAS(R) TaqMan(R) HCV test, v 2.0. The limit of detection (LOD)
and lower limit of quantification (LLOQ) for this assay is 15 IU/mL.
Results less than the quantitative range of the assay will be reported
as "HCV RNA detected, less than 15 IU/mL".

[adamben101]

Reread the results.  Something sounds amiss.  15IU/ml is the lowest quantitative measure on most labs, so you would never get back a quantitative test that said HCV was detected below that.  As you said, it's mutually exclusive from the undetected test.  I'm almost certain that your test means it's not detectable.

[flyinlynn]

Hi Liverman

If I remember my chemistry class correctly there was qualitative analysis as in quality or is there some of whatever you were looking for. Quantitative analysis is what is the exact quantity present. This test is also known as viral load test.

So the less specific test qualitative or Qual did not detect the presence of the virus. But the more specific quantitative analysis test Quant was able to detect a small amount of the virus but less than 15 IU/mL  which is the lower limit of detectability.

I am only a lay person so for a better answer contact your doctor. But I hope this helps.

Good luck
Lynn