regarding the senstive VL tests

I have tested VL throughout tx with the normal <43 test. I am planning to do my 24 week VL test with Heptimax in a few weeks. When using a sensitive VL test, if you are UND still, I'm assuming you should always test in the nomral range of the test you are using. In other words, I am hoping to be <5 with Heptimax. I know if there had been a breakthrough, I would go over 43, but I still want the sensitive test.

Is there are way that someone would ever be say between 5 and 43 and somehow still be UND?
In other words, if someone is truly UND, will they always test UND, no matter how sensitive the tests, whether it's <5 or <10 or <2? Or is is possible to have a low viremia count (under 43) and still be cured?
Thanks.

[nygirl7]

If you have obvious apparent viral load in your PCR testing then you are not undetectible. It's not as if you would only have 3 virons left in your whole body - and they do replicate and that number would grow.  This is different from the idea of occult virus that wouldn't show up as a positive in a simple blood test. So no you would not be cured.

However at my EOT 4 week test I tested with a count of 63....my doc said it wasn't a real positive to retest in a month and I did and I have always been UND ever since (four years). it could have been going off the meds that the virus tried to come back but my immune system did kick in and beat them in the end.......or it could just have been a mistake.  One will never know.

[Bali05]

I could write a long post about this.....
Bottomline is we want to be as undetectable as possible at ALL TIMES
As undetectable as possible means using the most sensitive and reliable test available.
In my book those are the National Genetics Institute PCRs namely for Quantative
the NGI QuantSure <2IU or for Qualitative the NGI UltraQual <2 . (both thru LabCorp)

For some reason my Hepatologist tells me the Quest TMA Qualitative NOT the
TMA Quantative (Heptimax) is most sensitive test available.

After talking to the labtechs @ the Quest Nichols Institute in Chantilly, VA  about
their TMA tests and NGI in California as well as my renowed Hepatologist

I now run NGI QuantaSure <2 and TMA Qual. <5  and that would be as "undetectable
as possible " for me.

BTW , yes you can have low level virus not showing up on standard <43 PCR.
You can even have a low level breakthrough not showing up on <43 PCR.
You an be positive on TMA , than negative and again positive on TMA
all while negative on <43. All these scenarios are rare but they do happen
and what that means for your tx and SVR is best discussed with your hepatologist.

[iwillbeatthis]

"For some reason my Hepatologist tells me the Quest TMA Qualitative NOT the
TMA Quantative (Heptimax) is most sensitive test available"

I'm confused about above. So those are 2 different VL tests?

If the Heptimax detects to <5, isn't that just about as good as it gets? I do my labs at Sonora Quest, so I wanted to do it there.
And I'm curious, have most people here tested with a sensitive test or have you just stayed with the <43?

[James10500]

As we all know there is no UND test meaning to zero.  When people say they are UND they mean UND relative to the boundaries of the test they took.  You could be less than 43 and greater than 5 on a heptimax test.  Heptimax first uses PCR <43, then if that's negative uses TMA <5, it's a combination of two tests.  But if PCR is greater than 43 the TMA is not used, obviously.

Wouldn't it be great if there was a test that measured to zero !!!

[Bali05]

"For some reason my Hepatologist tells me the Quest TMA Qualitative NOT the
TMA Quantative (Heptimax) is most sensitive test available"

I am confused about that as well.

For example the Quest website states their
TMA Qualitative has a lower detection limit of 10 IU.
When I called the Quest lab where the test is performed (Nichols Intitute) they
say both TMAs Quant and Qual are <5.
My hepatologist says the TMA Qual. is most sensitive because the Qualitative
assay can detect lower than the Quantative.

I prefer NGI but I also do not want to discredit my renowned hepatologist , so I run both
NGI Quant. and Quest TMA Qual.
For me that is as good as it gets for now.

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