Aa
qualitative vs quantitative (here we go again)
Ok, through the years I have notice great discussion regarding the measurement of vl and the machines used.
I an currently on viekira/riba with 3 weeks to go. I have had a baseline of around 10 million, which dropped to >15 when they measured at week 6. I recently had another blood draw, results not in yet.
The machine being used is COBAS TaqMan HCV test, v2.0 at LabCorp in Dallas Texas.
When my 6 weeks results came in my nurse called and quite happily told me I was UND. Which technically is not true since the results said "HCV RNA detected, less than 15 IU/mL.
I asked my nurse if they would do a qualitative test at EOT and she told me "they were the same thing". I was frankly too tired and nice to argue with her.... as they are not the same thing.
I remember reading around 2007 that "hr" (Dr Dietrich) posted that when the numbers get that low (and back then it was like >40 IU/mL they were were talking about, that it really did not matter because:
""If you stop treatment (EOT) and have still detectable virus circulating - real virus not false positives- then you have to assume that these viruses are now too crippled /mutated or under actual effective control of the immune system so that they cannot restart the infection=relapse. "
That being said , should I be concerned and ask my doctor to order a more sensitive qualitative test for EOT or just let it go.
One more thing... my EOT blood draw is scheduled for one week after my final dose. Shouldn't this be done closer to EOT so in case there is an increase in the vl (course I know huge increase would mean to stop tx) but if there were a slight increase might it be better to know earlier when there is still plenty of meds in your blood and then perhaps extend treatment 12 more weeks.
ps - I have little liver damage and am graded between a 1 and 2.
psps - am I overthinking all of this.
pspsps- this Dr. has treated lots of patients with harvoni and has had very good success....but he is not a specialist. He is a a gastro
thanks!!!
dm
.
I an currently on viekira/riba with 3 weeks to go. I have had a baseline of around 10 million, which dropped to >15 when they measured at week 6. I recently had another blood draw, results not in yet.
The machine being used is COBAS TaqMan HCV test, v2.0 at LabCorp in Dallas Texas.
When my 6 weeks results came in my nurse called and quite happily told me I was UND. Which technically is not true since the results said "HCV RNA detected, less than 15 IU/mL.
I asked my nurse if they would do a qualitative test at EOT and she told me "they were the same thing". I was frankly too tired and nice to argue with her.... as they are not the same thing.
I remember reading around 2007 that "hr" (Dr Dietrich) posted that when the numbers get that low (and back then it was like >40 IU/mL they were were talking about, that it really did not matter because:
""If you stop treatment (EOT) and have still detectable virus circulating - real virus not false positives- then you have to assume that these viruses are now too crippled /mutated or under actual effective control of the immune system so that they cannot restart the infection=relapse. "
That being said , should I be concerned and ask my doctor to order a more sensitive qualitative test for EOT or just let it go.
One more thing... my EOT blood draw is scheduled for one week after my final dose. Shouldn't this be done closer to EOT so in case there is an increase in the vl (course I know huge increase would mean to stop tx) but if there were a slight increase might it be better to know earlier when there is still plenty of meds in your blood and then perhaps extend treatment 12 more weeks.
ps - I have little liver damage and am graded between a 1 and 2.
psps - am I overthinking all of this.
pspsps- this Dr. has treated lots of patients with harvoni and has had very good success....but he is not a specialist. He is a a gastro
thanks!!!
dm
.
Question 2. What do these test results mean: “<15 Detected” or “<15 Not Detected”?
A “<15 Detected” means the assay was able to detect HCV RNA but was not able to accurately quantitate the viral load. A “<15 Not Detected” means the assay did not detect HCV RNA (Target Not Detected).This test is performed using the COBAS® AmpliPrep/COBAS® Taqman® HCV Test v2.0. The lowest viral load this assay can accurately quantify is 15 IU/mL, but the limit of detection is 10-13 IU/mL. Therefore, we can qualitatively report detection even if the viral load is under 15 IU/mL.
http://education.questdiagnostics.com/faq/FAQ22v1
A “<15 Detected” means the assay was able to detect HCV RNA but was not able to accurately quantitate the viral load. A “<15 Not Detected” means the assay did not detect HCV RNA (Target Not Detected).This test is performed using the COBAS® AmpliPrep/COBAS® Taqman® HCV Test v2.0. The lowest viral load this assay can accurately quantify is 15 IU/mL, but the limit of detection is 10-13 IU/mL. Therefore, we can qualitatively report detection even if the viral load is under 15 IU/mL.
http://education.questdiagnostics.com/faq/FAQ22v1
Although I could be wrong... I just notice that on my latest lab,.. it lists 2 locations for test... Dallas(which I always see) and Burlington , NC (which I never see).
And where it says "HCV Not Detected IU/mL" it doesn't say what machine was used, location , or anything.
My nurse could have left out a page or two... I know she left out the graph , which is cool to look at.
I will have to check the LabCorp portal , I guess , to see what was used to determine UND, .. .just curious.
I tried their portal before, but failed all the public records questions ( what is the length of your boat (uh, I have two), Who was your first manager?? ( I stared working at 11 and have never stopped, ... just bunches of questions with tricky answers , all the above, 2 of the above, none of the above.... impossible. So now , I have to send them a photocopy of my DL. A minor irritation but still, one more hoop.
dm
And where it says "HCV Not Detected IU/mL" it doesn't say what machine was used, location , or anything.
My nurse could have left out a page or two... I know she left out the graph , which is cool to look at.
I will have to check the LabCorp portal , I guess , to see what was used to determine UND, .. .just curious.
I tried their portal before, but failed all the public records questions ( what is the length of your boat (uh, I have two), Who was your first manager?? ( I stared working at 11 and have never stopped, ... just bunches of questions with tricky answers , all the above, 2 of the above, none of the above.... impossible. So now , I have to send them a photocopy of my DL. A minor irritation but still, one more hoop.
dm
Hey SSG,
Didn't you tell me it was a "walk in the park" compared to interferon/riba??
That really encouraged me and I wanted to say "thank you!"
I was trying to find that old post but could never track it down.
I was really concerned about round 2, after having suck a crappy time on interferon and almost decided not to treat again.
I should have never jumped into that original tx, but was so impatient, So this time I was thinking, "maybe I should wait, remember last time?"
And there are better treatments just around the corner (hard to believe) but I'm glad I jumped on the vike train. Thanks for encouraging!
dm
Didn't you tell me it was a "walk in the park" compared to interferon/riba??
That really encouraged me and I wanted to say "thank you!"
I was trying to find that old post but could never track it down.
I was really concerned about round 2, after having suck a crappy time on interferon and almost decided not to treat again.
I should have never jumped into that original tx, but was so impatient, So this time I was thinking, "maybe I should wait, remember last time?"
And there are better treatments just around the corner (hard to believe) but I'm glad I jumped on the vike train. Thanks for encouraging!
dm
you guys are right.
My labs machine does two things .. i can give you quantitive >15
AND it can give "HCV Not Detected IU/mL"
Which is just gave me today when I received my 9 week vl test.
AST 16 ALT 11
I am in shock.
3 weeks to go.
dm
My labs machine does two things .. i can give you quantitive >15
AND it can give "HCV Not Detected IU/mL"
Which is just gave me today when I received my 9 week vl test.
AST 16 ALT 11
I am in shock.
3 weeks to go.
dm
In my post above I should have said "unquantifiable"
"too small of an amount to detect - thus, no undetected status
should have said too small of an amount to be quantifiable
"too small of an amount to detect - thus, no undetected status
should have said too small of an amount to be quantifiable
I cleared on Viekira Pak and was less than 15 detected for a while. Everyone at my trial site (Turquoise for cirrhotics), cleared and one or two cleared even though they were less than 15 detected at EOT. With little liver damage, you have way greater than a 90% chance of clearing. Yes, I think you are overthinking this. Hang in there.
I had the same nervousness at my 4 week EOT labs that finally said "undetected". Every other VL test had come back as less than 20
I was tested every month during my 12 week Harvoni/Riba treatment and every 2 weeks for all other important liver lab work
Even though I finally reached that undedicated status at the end of my latest treatment (at 4 weeks), my doc and others in this group explained to me that if your lab measures less than 20 or 15, then it is actually too small of an amount to detect - thus, no undetected status
So, if your other labs look normal or better than they have in ages, you are probably cured. Still, it's agony to wait for those extra 3 months to get a definitive SVR designation
My relapse after treating with Sovaldi for 12 weeks, the labs at 4 weeks EOT went from undetected to VL of about a million and ALT and AST more than doubled
So, hang in there. I Insisted that they do the VL at 4 weeks the first go round (they wanted to wait 12 weeks) because I learned from the wise people in this forum that you can tell, generally, after 4 weeks.
Good luck to you. Sounds like you are in a good place to reach SVR!
I was tested every month during my 12 week Harvoni/Riba treatment and every 2 weeks for all other important liver lab work
Even though I finally reached that undedicated status at the end of my latest treatment (at 4 weeks), my doc and others in this group explained to me that if your lab measures less than 20 or 15, then it is actually too small of an amount to detect - thus, no undetected status
So, if your other labs look normal or better than they have in ages, you are probably cured. Still, it's agony to wait for those extra 3 months to get a definitive SVR designation
My relapse after treating with Sovaldi for 12 weeks, the labs at 4 weeks EOT went from undetected to VL of about a million and ALT and AST more than doubled
So, hang in there. I Insisted that they do the VL at 4 weeks the first go round (they wanted to wait 12 weeks) because I learned from the wise people in this forum that you can tell, generally, after 4 weeks.
Good luck to you. Sounds like you are in a good place to reach SVR!
Let it go….. if you have Hepatitis C it will come back with a vengeance after
treatment. You are in the process of killing the virus. Let it go. It sounds
like you are doing great.
….and yes stop over thing all this.
treatment. You are in the process of killing the virus. Let it go. It sounds
like you are doing great.
….and yes stop over thing all this.
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