America get a grip!!

[comeagain]

Why are you still using them tests that only shows < 600 or <500 or what it is.
They are stoneage not only makes it hard to do a prober tx strategi for  the patients, its also confusing to the rest of the world when sombody tells they story of relapsing after long time UND in tx.

I told my doc the other day about someone who had relapsed after 90weeks soc and beeing UND. And he said you dont know what test thay have used there, ( was he really UND he meant) they still using old tests in USA "I dont know why he added but they seems to be very slow to make chanses over there some times".

So stop beeing a laughing stock to the rest of the civilized world and tell your md, congressman or whathever to GET a GRIIIIP!!! and throw them old testes in the trash can were they belong!!

[comeagain]

not chanses  changes

[Trish77]

Yeah!!  Stop being a laughingstock and throw them old testes in the trash can where they belong!!!  Who's first??!!??



comeagain, forgive me .. I'm well aware that English is not your first language and yet you manage very well.  That line hit me SO funny at the implications of that... and I have to thank you for the really good laugh...it felt SO good. :)

I'll let the guys tell you what part of their anatomy you're suggesting should be going into the trash can...and I'm wondering what your age cutoff is.  :)

Trish

[desrt]

Excuse me , but I like my old testes.

As for the other, my tests going back over the last 6 years have all been <2/<5 - but I have first rate insurance. As with everything else in this sad world it boils down to $$$. We do not what we will but what we can. What are you on, the National Health?

[comeagain]

glad to make U laugh and it goes with stock aswell i supose.
I dont know what you mean by that remark age cutoff but I´m sure its nothing nice.
But come on if it had been in Nepal  or Ukraine or somewere it could have been unerstandable.

[geterdone]

I think comeagain may have been referring to several post here relating to <615 or something like that can’t remember but I have seen it posted here several times but did not follow the post. He may have referred it back to his doctor in conversation and this may be how he came to the conclusion that the US is using old test down to 615, I think.

jasper  

[geterdone]

and Trish, that was just freaking nasty.

[comeagain]

On the spot And we were talking about that theory that once  the virus is out of bloodstream,  its about giving livercells time to die.

[Trish77]

I apologize deeply and sincerely if that came across as nasty.  I truly do.  While it's all well and good to laugh at myself for double entendres, you take your knocks when doing that with people you don't know well.  Honestly, I am truly sorry to cause offense.  I had hoped that my explanation would prevent that but apparently not.

comeagain...my sincere apology to you is public but I'll explain to you in private what I meant.  I don't want to take up any more space in your thread with my comments.

Trish

[Trish77]

Well, I need to say this after all.

I apologize for the offense taken by my comment.  I've had my adventures in trying to use the French language here in my country and I'm reasonably conversant in sign language, having worked in the Deaf community for a number of years and having Deaf friends.  I have been the source of much laughter from the unintended misuse of my efforts in either language and never really took offense to that.  They weren't being nasty.. some of the misuses were downright funny and I laughed along with them.  

In no way were my comments intended to be nasty.  I apologize if that's how they came across.  

Trish

[Willy50]

Hey, I read your thread title and agree; no one should be using tests with low sensitivity.  I would also like doctors and clinics to do more frequent use of PCR's.  Good comment.

Thank you for the post and thank you for your sense of humor.  Trish was not laughing at you or your post.  She was laughing at how the inclusion of one letter; the letter "e" so completely changes the meaning of a sentence.  There is a large difference between throwing old outdated tests (PCR's) in the trash and throwing outdated (and perhaps unused) testes in the trashcans.  

No worries (I hope) and welcome to the forum friend.  

best,
Willy

[comeagain]

Ty for the apalogize. its accepted I know I come about provokativ with laughing stock  but there is some truth in it, and maybee if you refer to your doc that people from a small country
( 9milj) like Sweden, think its odd that you in a big rich country using tests ( not testes this time) that are out of age and missleading aswell, maybee saying that could speed the evelopment up a little bit, or at least give you when saying so a better test bad insurance or not.

btw it was the congessmans testes i was talking about

[Trish77]

Thank you for that .. and for the additional laughter on the congressman's testes :)  What I meant by the "cutoff" date was.. hold old do you suggest American men need to be to make them a candidate for throwing their testes in the garbage.  Although...I suppose "cutoff date" could be taken to mean the removal date. :)  

Seriously though.. I agree with you on the test sensitivities .. dsrt's comments noted.

I have dealt with that here in Canada to some degree with no VL test having anything higher than a 1.3 mil IU/ml upper limit.  Apparently that is about to change.. however I find it frustrating to know that that's where we're AT.  

Regards,

Trish

[meki]

I didn't think anyone was being rude...

And I think comeagain was intentionally trying to be funny as heck.

And it was...

LMAO!

But - even if comeagain wasn't trying to be funny --- LOL - -- it's good to have a joke MAGICALLY appear on the boards...

Thank you for the grin all of you.

Hugs,

Meki

[jmjm530]

As of the last time I checked, the most sensitive test used in Sweden (and the rest of Europe) was 50 IU/ml. At that same time, many of us here were using tests that went down to 5 IU/ml, and some even down to 2 IU/ml. The "600 IU/ml" test you refer to is probably a bDNA, and is quite appropriate for testing viral load *pre-treatment*. During treatment, most knowlegeable hepatologists in this country use the more sensitive tests.

[geterdone]

I also apologize for jumping to conclusions of what has been written but there have been times here when something said in jest got so blown out and twisted that there were a lot of hard feelings left in its wake. I guess I was focused on trying to understand what comeagain was saying and because of the language difference, I overlooked the “Testes” part and Trish’s counter reply to that and perceived the reply as lets say unjust given comeagain is somewhat new here. Actually while grocery shopping and thinking back it did seem out of charter for Trish to insinuate any preemptive insults and my apologies to you also, Trish.

Yeah, I know Elaine dog gone it, (head hung, looking at the ground, shoulders slumped, kicking the dirt) I’m sorry all, now can we get an ice cream Elaine… Please!!! LOL!

jasper

[meki]

Love you Jasper... You're too cool.

[Trish77]

Jasper, I admire someone who has the guts to speak up about a perceived injustice and it also gave me the opportunity to address it, so no harm done.

Aw shucks.. now we're all one big happy family again... and I want ice cream too!!  Maple walnut please Elaine????  :)

Trish

[eureka254]

It's a great day when as Americans we can wake up, test our testes (and those of our congressman), get testy, talk, learn, and laugh about it, and go to the family table for ice cream... with nuts !!

lmao :)
~eureka~
Gives thanks to all (and to God for all) while screaming for ice cream

[orphanedhawk]

The problem as I see it, are all the unknowns. If your doctor is as honest as mine, the answer to many questions concerning HepC is; we don't know.

Are these old tests a problem? and to whom? I don't know:)

[CockSparrow]

Jim
Europe seems to be using Real Time RT-PCR tests nowadays. Both Zazza and Comeagain seem to be using Roches COBAS Taqman PCR Test. So am I for that matter.

Real-Time PCR Assays for Hepatitis C Virus (HCV) RNA Quantitation Are Adequate for Clinical Management of Patients with Chronic HCV Infection
JOURNAL OF CLINICAL MICROBIOLOGY, July 2006, p. 2507–2511 Vol. 44, No. 7 0095-1137/06/$08.00_0 doi:10.1128/JCM.00163-06

The linear range pf these tests is mind blowing
COBAS TaqMan 43-69,000,000
Abbott 12-100,000,000

The assay meets the Second WHO International Standard for HCV RNA. The lower limit of detection is 12 IU/ml, with _95% probability. The dynamic range of the assay extends from 12 to 100,000,000 IU/ml. The Abbott RealTime HCV assay detects and quantitates genotypes 1 to 6.

The LoD of bot are pretty good as well.
Cobas TaqMan HCV (Roche Diagnostics, Meylan, France), with a detection limit of 15 IU/ml (7), and the Abbott Real-Time HCV quantitative assay (Abbott Laboratories, Rungis, France), with a detection limit of 10 IU/ml.


End-point-PCR-based assays (Cobas Monitor and LCx) and the signal amplification assay (Versant; Bayer) should now be called “old-generation HCV RNA quantitation,” as opposed to “new-generation real-time PCR” assays, for at least the following three reasons:
(i) the absence of complete automation,
(ii) the need to dilute for quantification above the upper range (8), and
(iii) the fact that the former assays were standardized with the first WHO panel, and due to the different secondary standards used for calibration, the IUs measured by these assays are different.

In a recent comparative study (11), we demonstrated that the absolute values obtained with these assays are different and that the HCV RNA viral load decline, assessed by different assays during antiviral therapy, can give different results regardless of the use of international units.

The viral loads measured by the Abbott and Roche assays were highly correlated

CS

[zazza]

The last time I checked, the most common test in Sweden is HCV RNA Taqman, range 15 IU/ml to 69'000'000 IU/ml. I asked why we are not using even more sensitive tests, and the reply was that when you get down to such a low viral load as 2, 5 or 15 IU/ml, there really is no difference between the tests, they are just as good. It is too difficult to measure exactly at this low a viral load.

As an example, I can mention that I was told by the lab doctor that my borderline test at week 12 (detectable but too low to quantify) equaled anywhere between 5 and 20 IU/ml.

And when it comes to testes and Comeagain, I guess I am the only one on this board who has personal experience of that. :)

[Bobby1952]

    Its the HMO's dammit. My HMO's Lab has 2 tests. A tma Qual that is 10 IU.  And a PCR QUAN. that is 615 IU. That is it. Their Lab doesn't have any other tests, period.

    So we are stuck with what they have,

Bobby

[jmjm530]

You obviously checked later than I did. My "Swedish" check was when I started treating around three years ago. At that time, Lindahl and Company were using a sensitivity of 50 IU/ml in their HDV pilot study, while I was using Heptimax with a sensitivity of 5 IU/ml. As to your "personal experience", previously noted, I'm sure many of us would like for you to expand on that thought :)

-- Jim

[jmjm530]

That would be "HDR" (as in high dose ribavirin) and not "HDV" as written.