The sensitivity of the test is not nearly as important as the following two factors: (1) the fact that the PCR tests are being measured AFTER treatment concludes, and (2) the testing repeatedly indicates negativity for a sufficient duration after treatment concludes. Typically/traditionally if you consistently test UND by a reasonably sensitive PCR test (say <50 IU/ml or less) 6 months after concluding treatment you are considered SVR. Although more recent studies have found that a 3 month post tx UND also dictates an SVR status with nearly 100% certainty. And the reason the sensitivity of the test isn't that big of an issue is because in the event a true relapse occurs, the VL nearly always skyrockets well above even the most insensitive test available today. Howevere there are rare reports of some people maintaining a low level chronic infection that, for instance, may not be detected with a 615 IU/ml PCR but would be detected with a 10 IU/ml. So just to be on the safe side it's best to use a truly sensitive test for your 3 or 6 month PCR so you can be as sure as possible.
It's as much about when the test is done as what the sensitivity is. I'd rather be undetected with a test that only has a sensitivity of <50 at one year pst-tx than be und on a <5 test one week post-tx.
Oh, and the "exact words" printed on your test result typically will only be your latest blood test result. It never says "Congratulations you're SVR!" or anything like that. My latest 24 week post tx PCR said "<30 IU/ml NO HCV RNA DETECTED", which simply means that not HCV virions were detected within the sensitivity this particular test affords.
A qualitative would be fine, you're only trying to establish if you're still UND. In the event you are detectable you can always retest to get a quantitative later. But as long as the qualitative has the sensitivity you deem acceptable, then it doesn't make any difference. If you're UND, the quant and qual tests give the exact same info.
The old definition of SVR is when you have undetectible virus six months after you stop taking the treatment drugs. A newer study suggests you may be SVR if you are UND three months after stopping the treatment drugs, assuming you did not have stage 4 liver damage.
All the notations you made, above can represent UND. It depends on which test you take, as different tests have different sensitivities. If you're looking for a simple to order, good all around test for SVR, I suggest either "Heptimax" by Quest Diagnostics or the "HCV RNA TMA QUAL" also by Quest Diagnostics.
When my doc first started testing me though it was straight PCR <315 and I didn't like that once i became UND so I asked specifically for the more sensitive tests to be sure because my VL was at 411 at week 4 and 419 at week 12 so it was very important to me to know that i was truly UND and not at like 200 or something. So you see to me it was crucial to have the correct testing done as I was one of the oddballs with a low VL.
Then I had the false positive with a "60" at 3 months post and and so he went back and did the same testing Jacobson had done and i was pretty sure that number went to <2 because he believes in giving the best test possible.
SVR 10 months now.
I agree 100% from my point of view - the most sensitive testing possible is important.
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