Confusion about UND

[jankar]

What does UND really mean?

I had a result of UND<15 at week 4, someone else a UND<10 at week 4.  Is this result sensitive enough to base a decision on 24 weeks or 48 weeks?  Another suggested we needed weekly or daily tests in the first four weeks to make a decision, another suggested that those results are still detectable and if present at week 12 in the same levels, needs to result in 72 weeks treatment.

Thanks for all the research responses - I am particularly interested in results for 1b on Pegaysus 2a and Ribavirin as those results differ I think to the results from all Geno 1's and Pegysus 2b

[geterdone]

I am going for another pre-surgery physical next week for the cataracts in the left eye and along with the std blood work and lipid test I will push for the pcr as well. My previous three pcr test have been Lab corps HCV N G I quanta sure LC#140639 down to <2 but my insurance will no longer pay for these test because Quest is the preferred provider. I know we have had this discussion before and you have favored the Quest lab test over the Lab corps test in prior posts and as with the present, so my question is what would be comparable to the lab corps. test down to <2 in the Quest testing? Is there a quest test that goes down to <2 or should the quest down to <5 be good enough being post treatment 11 going by the original start date?

Thanks

jasper

[zazza]

We still do not have Starbucks in Sweden!

[zazza]

Oops, didn't mean to shout, just emphasize. You probably are correct in that we mean the same thing, it is not always easy to determine, but it gives a reason to keep the discussion going. :)

My test from 2005 says this, no measuring range mentioned, so I wouldn't be surprised if it did not go below 50 IU/ml:

Examination and test type:
DETECTION OF VIRUS RNA
EDTA-plasma

1. Hepatitis C virus RNA   DETECTED

2. HCV genotype:
Type 1a detected

3. HCV RNA Quantative: 600,000 virus copies/ml
Test examined with bDNA version technique.

4. HCV RNA Quantative: 120,000 IU/ml
Test examined with bDNA version 3 technique, expressed as IU/ml.


I understand this bDNA technique is not used anymore. It is out of date now. Correct? Still without me knowing it, it was this old test result they used as my baseline. I was kind of upset when I understood they had used a one and a half year old test result for that.

[jmjm530]

prev post should read in part...

The principle that there are advantages to using the most sensitive test does not mean you *shouldn't* be confident..

[jmjm530]

Trinity,

The principle that there are advantages to using the most sensitive test does not mean you should be confident in using a test with a limit of 10 IU/ml, which is quite sensitive. I use test(s) with a lower limit of 5 while LabCorp offers an lower limit of 2.

Zazza

Well, at least in the U.S., capital letters suggest "shouting" if not emphasis and the way you used them at a minimum suggested I was not listening to what you said, while in fact we had the same position. As far as the "2 years", yeah, time flies when you're having "fun" LOL. I finished tx 2 years ago but *started* tx 3 1.2 years ago in 2005. That was when I corresponded with the researcher in Europe where the most sensitive tests then were 50 IU/ml, according to the researcher. But at the same time -- 2005 -- I was using a test that went down to 5 IU/ml and LabCorp I believe had their NGI Quantasure (not sure on that) which went down to 2 IU./ml. I believe we also had Starbucks in this country several years before Europe :)

In summary, everything I've read and heard suggests using the most sensitive test available without going through too many hoops. I prefer Quest Labs to LabCorp so I'm not going through a hoop to get from 5 to 2 IU/ml. If I was in a trial that used a test with a sensitivity of 10-15 IU/ml, I'd feel comfortable. And if I lived in a country where the tests only went down to 50 IU/ml, I'd also feel relatively comfortable although not as comfortable with some UNDs as with a more sensitive test. My consulting hepatologist remarked at one point -- the discussion was extension or not -- that not only was I UND for "x" weeks, but UND down to 5 IU/ml. Obviously the distiniction was important to him.


-- Jim

[kciav]

Thanks!
We will be looking for the Not Detected next test.