pcr test results

[dbuck67]

got my 4 week PCR test results less than 12 doctor said that means low but still detectable can someone elaborate

[Bali05]

I think she was still detectable @ wk4 and I hope she will be undetectable @ wk12 or a lot sooner. The earlier you become truly undetectable the
better your chances for SVR. In terms of how long dbuck67 should tx
should be determined between her Dr. and her considering all circumstances and apparently that`s 24wks so far.

[JamesJ2013]

Cosidering the dbuck67's case, do you think she is RVR or otherwise?

[Bali05]

I never commented on dbuck67 `s tx protocol , neither do I know
her circumstances , I simply elaborated on the test result as originally asked by the poster.
You posted "PCR result showing <12 IU/ML is know as undetectable "  and it is not . It is simply <12 and can still be detectable as in dbuck67`s case. In most cases from what I know people that are
<12 are indeed UND but not always.

[JamesJ2013]

Yes its good to know exact VL by most sensitive tests but <12 IU/ML at weak 4 (RVR) means tx duration should not be more than 24 weeks for type 3 and in this case dbuck67 is right in saying that she will do 24 weeks.

[Bali05]

Detected is detected . Whatever tx protocol is executed depends on the
meds  It is a good idea to see when you become UND by most sensitive test. A forum friend of mine his viral load went down to 2 IU and stalled
there.
My hepatologist ran more sensitive tests (Quest Qualitative TMA) when I got closer to UND to be sure.

[JamesJ2013]

But <12 IU/ML will remain <12 IU/ML wheather detected or not-detected (depends upon the assay used). The important point is what doctors consider RVR; Less than 12 IU/ML at week 4 is considered RVR.

[Bali05]

Log IU/mL                 IU/mL         Interpretation
< 1.08 Log IU/mL  < 12 IU/mL       Detected

[Bali05]

OOOps that table with  its spaces did not post correct.

Here it is again hopefully it pasted correctly

Log IU/mL              IU/mL              Interpretation
Not Detected      Not Detected   Target not detected
< 1.08 Log IU/mL  8.00 Log IU/mLc > 100,000,000 IU/mLc > ULQ

i

[Bali05]

You have not posted exactly which test your Dr used but for example
here is how the  Abbott RealTime HCV which is
a standard test that quantifies down to <12.
reports its possible results.

log IU/mL                      IU/mL                        Interpretation

Not Detected            Not Detected                 Target not detected
< 1.08 Log IU/mL         8.00 Log IU/mL      > 100,000,000 IU/mL                 > ULQ

As you can see if undetectable it would say Not Detected whereas
<12 is Detected. The test will not report <12 as undetected.

<12 IU expressed in log ist still <1.08 log and IU/ml stands for international units per ml. Depending by which test was used 1 IU = 2-5copies of virus per ml. Lets say your viral load is 10 IU which is <12 IU it could be around
20-50 copies of virus per ml in your blood. Now if you multiply that by the
liters of blood in your systems that is still a lot of virus.

Regardless of your tx decisions it helps to understand these things
and it can be very important for future reference to find out exactly
when you became truly UND .

Personally would run another very sensitive test immediately. Chances are
you are UND by now but hey if I were you I would want that in writing !

b

[dbuck67]

yes that's what I understand to be true now thank you. in any case im doing the 24 weeks of treatment no matter what it is right now and am very positive that this will work for me and I will be cured

[JamesJ2013]

PCR result showing <12 IU/ML is know as undetectable and you are RVR as far as I know.

[Bali05]

From your Dr`s statement it appears your test result is Detected and the test
used can only quantify down to 12 , hence below 12.
There are more sensitive tests.
Labcorp`s NGI QuantaSure Test Number: 140639  quantifies down to  2 IU
When you are already below 12 however you really don`t need to quantify any more you just want to now if virus can still be detected and for that I would run
the Qualitative version of the Quantsure which is the NGI UltraQual  Test 140609
if it is still available if not there is Quest Qualitative TMA which is slightly less
sensitive and more prone to false positives.

[dbuck67]

thank you for the information. I will be asking for the paperwork and will post it

[hrsepwrguy]

Also for future reference, you should request a hard copy of all your test results and keep them in a file, if you have any more questions it takes the guess work out of it, they are yours and have every right to a copy

[hrsepwrguy]

If she said it is below 12 it probably means undetectable, I have looked and couldn't find any PCR test that had a LLOQ (lower limit of quantification) of 12 iu/ml with a lower LLOD (lower limit of detection), all the one's I saw were LLOD and LLOQ of 12 iu/ml, which would mean that below 12 iu/ml is undetectable by the test taken.

[dbuck67]

all she said was the treatment is working and the test showed less than 12 that's all I know. I never knew my status when I started treatment only that I am grade 1 stage 2

[hrsepwrguy]

Ok, I looked at your profile and I see you are a geno 3 on 24 wk SOC treatment, being detectable at 4 weeks (not RVR) really changes things for geno 3's, has your doc said anything about extending treatment.

Abstract

Genotype 3 is a common type of HCV infection, and standard therapy using pegylated interferon (PEG-IFN) and ribavirin (RBV) is quite effective in these patients. While a short course of 16 weeks may result in comparable end of therapy responses, relapse rates are often high. A 24-week course is therefore preferable, and is expected to result in sustained virological response (SVR) rates of more than 70%. The 24-week course is especially recommended in the presence of steatosis (often associated with Genotype 3 infection), fibrosis stage two or more, high BMI and high viral load. In patients who do not achieve a rapid viral response (RVR) with combination therapy, an extended course up to 48 weeks should be considered. While not as definite as for genotype 1 patients, the presence of the CC variant of IL28b could help in the initial prognosis and the need for additional treatment, if an RVR is not achieved. The role of directly acting antiviral agents (DAA) has not been fully evaluated in treatment naïve, non-responders and relapsers in genotype 3 patients. Initial results with the cyclophilin inhibitor Debio-025 are quite encouraging. There is an urgent need for large clinical trials using DAA and host modulators in patients with G3 infection.

http://onlinelibrary.wiley.com/doi/10.1111/j.1478-3231.2011.02715.x/full

[hrsepwrguy]

Do you have a copy of the results, if so please post exactly what it says, if not, get a copy and post exactly what it says. There are several different PCR tests on the market, so anyone answering would be guessing as to your docs interpretation

Have a great day