Aa
OH NO...got paperwork back of VL...JMJM???
I can't beleive this. I don't know what to do. I am so confused. I was told that they did a PCR and I was UND over the telephone. Thats not what the paperwork says. It says they did a HCV QN by bDNA. The "cheap" one? Anyway, it says, serum <615.
The Assay dynamic range is 615 IU/mL to 7,692,310 IU/mL. i am very discouraged. Can anyone tell me what this means?
The Assay dynamic range is 615 IU/mL to 7,692,310 IU/mL. i am very discouraged. Can anyone tell me what this means?
It depends on the test. Sometimes the multiplier is not "5.2". See posts "C33" and "C32" above.
-- Jim
-- Jim
Well I've learned a few things about that. For 'whatever' reason, my hep doc doesn't have an account with Quest. So he just gives me a sheet with the tests he needs and I go directly to a Quest 'outlet' and have the test done and pay on the spot. Heptamax is $475. Initially, when I had the genotyping and all the tests it was nearly $1500. So I go to my Primary Physician and he tells me, 'Don't do that. I have an account and get a discount. Still, it's $225 with him, but that's better than $500.
Hep doc @ $150 a whack, blood test running about $350/mo. Even with the free meds, I'm still talking $500/mo out of pocket.
I was thinking about a T-shirt with 'What's YOUR viral load ?'
Hep doc @ $150 a whack, blood test running about $350/mo. Even with the free meds, I'm still talking $500/mo out of pocket.
I was thinking about a T-shirt with 'What's YOUR viral load ?'
That's cool. At others have said, you are non-detectible, so congratulations !!! No need to call doctor IMO.
BTW the bDNA is not a "cheap" test, in fact probably more accurate than a more sensitive PCR. Forgot if this is post treatment or during treatment and what week?
-- Jim
BTW the bDNA is not a "cheap" test, in fact probably more accurate than a more sensitive PCR. Forgot if this is post treatment or during treatment and what week?
-- Jim
Good Grief. I guess I am just throwing a tantrum, because I thought they did a PCR...at least they could have done a TMA. I just researched all of them so I guess I got my answers. Sorry for panicking and posting like I did. I just hate it that we can't know for sure that this virus is completely gone. I hate this. Sorry for freaking out. Thanks all and blessings to ya, Mkeela
UND at week 10.(my hepa people only do VL at 12 weeks, but I complained till the finally did one..hee hee)Did shot 11 last night. Only have to go 24weeks because of the VL. My bloodwork looks amazingly good so far, just suffering from itchyness, tiredness, flu like symptoms, and mood swings. I feel bad for feelin sorry for myself now..LOL...I love you guys.
If it were me, I'd test again at week 12 per normal protocol. That would be the day before your 13th shot. A good test to ask for would be "Heptimax" by Quest Diagnostics. It is very sensitive and goes down to 5 IU/ml. In fact, any further tests should be senstive tests like Heptimax. It's not unusual that the doctor gave you the test he did. Just not the best test IMO. And certainly the wrong test from here on out since you are below its limit. But as Mike said, not to worry. Chances are that you will also be non-detectible with the more sensitive test.
Be well.
-- Jim
Be well.
-- Jim
Alternatively, you could ask them to run a more sensitive PCR or TMA on the same blood, assuming the lab still has enough left. If you go this route, make sure whatever test they run has a sensitivity of at least 50 IU/ml and preferably 10 IU/ml or under.
Good suggestion Jim. When I scheduled to have next week's PCR drawn, I checked around to find out what test would be used and it's sensitivity before I made the appointment.
I would have prefered the <5 but settled for the <50 at this point as all I need to show, according to the statement at my last follow-up, is a 2 log drop over the 12 wks of 1400 mg of riba from my original baseline of 72,000,000 last January. I figured UND <50 certainly is more than the 720,000 required for the 2 log drop, and if it is UND, then I can pursue a <5 test for a more precise measurement.
I would have prefered the <5 but settled for the <50 at this point as all I need to show, according to the statement at my last follow-up, is a 2 log drop over the 12 wks of 1400 mg of riba from my original baseline of 72,000,000 last January. I figured UND <50 certainly is more than the 720,000 required for the 2 log drop, and if it is UND, then I can pursue a <5 test for a more precise measurement.
Another good <2/<5 test(depending if you're talking copies or I.U.) is the 'Quantasure' from LabCorp.
As I understand it, bDNA is the most accurate at measuring what your viral load is, if you have a viral load, and it is higher than 615.
TMA is the most sensitive at detecting the absence/presesence of virus, but is doesn't measure what it finds.
If you expect to find virus (like at baseline) bDNA is a good choice. If you expect you may be UND, TMA is a good choice. My doc will usually tag a bDNA onto the TMA even when UND is expected, presumeably as a redundancy. I prefer TMA over PCR because I've read a number of published studies on it's accuracy. Sensitive PCR may be just as good though. Google 'tma residual viremia'.
As Jim says, Heptimax is another good way to go.
TMA is the most sensitive at detecting the absence/presesence of virus, but is doesn't measure what it finds.
If you expect to find virus (like at baseline) bDNA is a good choice. If you expect you may be UND, TMA is a good choice. My doc will usually tag a bDNA onto the TMA even when UND is expected, presumeably as a redundancy. I prefer TMA over PCR because I've read a number of published studies on it's accuracy. Sensitive PCR may be just as good though. Google 'tma residual viremia'.
As Jim says, Heptimax is another good way to go.
A PCR <50 is considered sensitive and should be fine. In fact, as of the last time I checked, that was the most sensitive test used in the European trials -- in other words <50 was considered non-detectible for all practical purposes.
That said, what lab are you using? If it's Quest, you can have the PCR reflexed (automatically re-tested) to a qualitative or quantitative TMA if the PCR shows <50. That way you only have to get stuck once :)
Good luck and be well.
-- Jim
That said, what lab are you using? If it's Quest, you can have the PCR reflexed (automatically re-tested) to a qualitative or quantitative TMA if the PCR shows <50. That way you only have to get stuck once :)
Good luck and be well.
-- Jim
LOL. I love it. Brand loyalty :)
Seriously, Heptimax is an excellent test and I used it during treatment and for my week 6 post treatment test.
Then I switched to Quest's HCV RNA Qualitative TMA that uses Bayer Versant Technology for my 12 and 24 week VL tests. Like Heptimax, this TMA also has a sensitivity of 5 IU/ml.
The latter, as it's name suggests is a qualitative and gives the results as either "non-dectible" or "detectible" without a VL number. This type of qualitative is also an excellent choice once you've become non-detectible via a less sensitive test. LabCorp also has a very sensitive PCR that goes down to 3 IU/ml, I believe.
If GO uses Quest, one option would be to have his PCR reflexed to the Qualitative TMA mentioned above. In essence, this would be Heptimax with a "twist". The actual Heptimax is a two-part test that uses a real-time PCR with sensitivity of 50 IU/ml. If negative, the test is automatically reflexed to a quantitative TMA with a sensitivity of 5 IU/ml.
-- Jim
Seriously, Heptimax is an excellent test and I used it during treatment and for my week 6 post treatment test.
Then I switched to Quest's HCV RNA Qualitative TMA that uses Bayer Versant Technology for my 12 and 24 week VL tests. Like Heptimax, this TMA also has a sensitivity of 5 IU/ml.
The latter, as it's name suggests is a qualitative and gives the results as either "non-dectible" or "detectible" without a VL number. This type of qualitative is also an excellent choice once you've become non-detectible via a less sensitive test. LabCorp also has a very sensitive PCR that goes down to 3 IU/ml, I believe.
If GO uses Quest, one option would be to have his PCR reflexed to the Qualitative TMA mentioned above. In essence, this would be Heptimax with a "twist". The actual Heptimax is a two-part test that uses a real-time PCR with sensitivity of 50 IU/ml. If negative, the test is automatically reflexed to a quantitative TMA with a sensitivity of 5 IU/ml.
-- Jim
I'm hoping one of their reps will read it and cut me a discount. I don't have insurance and it is a kinda pricey test.
I'm willing to wear a logo T-shirt.
I'm willing to wear a logo T-shirt.
I heard it the same as GoofDad regarding Bdna as the most accurate.
However, I was told that a real time PCR is more accurate than a TMA in the sense of false positives or false negatives due to contamination or other reasons, since there is so much amplification involved with TMAs.
To tell you how neurotic I was, at week 12 post treatment I had both Heptimax and a qualitative TMA. Since Heptimax is actually two tests -- in effect I had three tests -- a quantitative PCR, a quantitative TMA and a qualitative TMA. Fortuantly the results were consistent or I would have had one big headache. If I were over the top neurotic, I might have added in a bDNA to the mix. Actually thought about it. LOL.
-- Jim
However, I was told that a real time PCR is more accurate than a TMA in the sense of false positives or false negatives due to contamination or other reasons, since there is so much amplification involved with TMAs.
To tell you how neurotic I was, at week 12 post treatment I had both Heptimax and a qualitative TMA. Since Heptimax is actually two tests -- in effect I had three tests -- a quantitative PCR, a quantitative TMA and a qualitative TMA. Fortuantly the results were consistent or I would have had one big headache. If I were over the top neurotic, I might have added in a bDNA to the mix. Actually thought about it. LOL.
-- Jim
Nope, 2b...I stopped feeling sorry for myself earlier, thanks all for reminding me of my personal blessings. :)
LOL. How about "I'm sensitive" for the front of the shirt :)
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Seriously, I hear you can "negotiate" with Quest on prices if you're paying out of pocket. I think the insurance companies only pay a fraction of the "list" price. Always best to speak to one of their supervisors.
-- Jim
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Seriously, I hear you can "negotiate" with Quest on prices if you're paying out of pocket. I think the insurance companies only pay a fraction of the "list" price. Always best to speak to one of their supervisors.
-- Jim
Actually, if you're paying out of pocket, once you test non-detectible by Heptimax, you might just want to use their
Quest's HCV RNA Qualitative TMA for all future tests, assuming the qualitiave costs less.
Quest's HCV RNA Qualitative TMA for all future tests, assuming the qualitiave costs less.
If you're still worried you could have another more specific test but, in my experience, when one relapses the viral load jumps and everyone I know who relpased tested way beyond 615 so my guess is you're in good shape. Mike
What is the difference between IU/mL and copies as desrt mentioned in C10? I can't navigate through the archives and find the threads that I remember seeing the discussion in.
I-Horn: I was thinking about a T-shirt with 'What's YOUR viral load ?'
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I like it but not sure it will get you many dates :) $225 sounds like a good price indeed, but maybe you could do better with just the qualitative TMA. Then your T-shirt could read "Detectible ?" on one side and "Non-detectible?" on the other. Still probably not a great date shirt.
-- Jim
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I like it but not sure it will get you many dates :) $225 sounds like a good price indeed, but maybe you could do better with just the qualitative TMA. Then your T-shirt could read "Detectible ?" on one side and "Non-detectible?" on the other. Still probably not a great date shirt.
-- Jim
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