Hep C viral load too low to determine genotype

[Sma1027]

I have had Hep C for 10 years, never had insurance to cover treatment.  Finally i get the referral, goto the Gastroenterologist, get labs and a VCTE.  I told the specialist my normal doctor did bloodwork and that my count was low and she was confused.(265) at the time.  Counts from this week are about 300.  The nurse reached out today and said that because the viral load is very, very low, the genotype couldn’t be determined-therefore she doesn’t think my insurance will pay for treatment.  She said she will get back to me in a week or so after they figure out what to do.  I saw other posts on here that were similar, but without any follow-up.    Will insurance turn there back bc of this!  Seems absolutely crazy to me, I’m still infected with the virus.  I really want to get this taken care of.

[flyinlynn]

An "Undetected" or "Indeterminate" hepatitis C virus (HCV) genotype result does not rule-out active HCV infection. Test results should be correlated with routine serologic and molecular-based testing, as well as clinical presentation. Specimens with indeterminate results will be automatically evaluated with the subsequent test HCVGR / Hepatitis C Virus Genotype Resolution, Serum.
Known cross-reactivity between the assay probes and various HCV genotypes limits the ability of this assay to identify multiple HCV genotypes present in a given specimen. Such cross-reactivity or the actual presence of multiple HCV genotypes in the same specimen may result in an "Indeterminate" or multiple/mixed genotype result.

[flyinlynn]

The good news is the relatively new DAA hep c meds work on most genotypes so that likely won’t be an issue.

As far as insurance the only way to know is to ask your insurance provider. There are so many types of insurance no one here can answer that for you.

Good luck!

[Sma1027]

Thank you!  I’m concerned that she said without the genotype they may not be able to treat it and then on top of that insurance might not cover it.  I guess I will find out next week, she also said if it isn’t covered we may have to wait a few months and then re-draw labs.  Thanks for taking the time to respond-I’m so stressed out over this.

[flyinlynn]

I had hep c for 37 years before the new treatments were approved and I was finally cured. I developed liver cirrhosis after 30 years of infection. Hep c takes many years to decades to cause damage for most people. Only about 20% of people with hep c for 20 years will develop liver disease.

Epclusa is a pan-genotype treatment it does not matter which genotype you have..

“EPCLUSA 98% Hep C overall cure rate

In studies of genotype 1-6 patients without cirrhosis or with compensated cirrhosis.”

https://www.epclusa.com/

As to your insurance concerns that is up to your insurance provider. Don’t worry about your nurses opinion get a real answer from your insurance.