more sensitive pcr

[cruelworld]

i went to labcorp a few months ago to get the more sensitive test
(down to 2) but i didnt do my homework and did not have the actual test code number
for their computer. they automatically just gave me the quantasure plus which only has a sensitivity down to 10.
what a disappointment. quantasure plus, this is their version of the heptimax except only half as sensitive  but same price range. in search of the better test i finally got through to someone at their office and they found the test
listing, its called NGI quantasure, code # 140639. its range is small, 2 million to 2. it is designed for tissue transplant testing. hepatitis patients and their docs dont normally ever request this. it is also twice as expensive a $714. if this exact code is not specified by your doc you will not get this test. maybe ill make it in this week
to get it and if im lucky i can say im more undetectable than you regular blokes!
in the practical world i dont know if this is justified or even meaningful but i know it would make me feel better so thats good enough by itself. it might also be interesting and revealing to see fluctuations between 4, 3, 2 and less then 2. especially towards the end of the shot cycle were the interferon has dissipated from our system. ive never seen anyone on the forum with these test results and they might show us things we can never see from the heptimax down to 5.

[mikesimon]

I suspect that when the tests become extremely sensitive we are likely to find traces of virus remaining in the serum of SVRs. I have been serum undetectable since April 2003 < 5 IU/ml and I test monthly. Yet small traces were found on biopsy. So what does that mean? Can I be distinguished because I am immunosuppressed and a transplant recipient? Perhaps, but I seriously doubt that. Logic seems to suggest that because I am immunosuppressed the virus would more more likely replicate to serum detectability than it would in the general population.
In response to your hypothetical: "And then let's say we did a 10 vial test like HR mentioned and found out we were still detectible but somewhere well below 1 IU/ml. The question now becomes what do we do?"  
I believe in that case we should proceed as if we are undetectable - like we would be with less sensitive tests. I assume you believe that there is absolutely no trace of HCV in SVRs but I don't agree with that. As I have said before, I think there is a type of truce in SVRs between the virus and our immune system. And that's just dandy with me. I got lab results from this Wednesday and my ALT 14/ AST 18/ GGT 11.
I think I'm well even if I do have a few traces of HCV hanging out in my liver.
Mike

[geterdone]

Thanks! for the link.

jasper

[jmjm530]

First, we're assuming that these super virions (I'll call them "stragglers") will indicate relapse. Studies will have to show this. And yes, do you extend to 72 weeks with a negative TMA but positive ten vial test at week 47 or not? Without study data, you are in unknown waters because: (1) the extension may be unecessary, i.e. you may be SVR anyway; or (2) the extension may still result in relapse because those straggers are in actuality "super virons" like you named them. That said, the extension might result in an SVR in an otherwise relapse scenario. Many more questions than answers.

-- Jim

[geterdone]

Ok jim, so it’s getting closer to post time here for me and after reading this thread it would be in my best interest to hound the doc about getting the Labcorp test called HCV NGI ultraqual LC#140609 before the end of TX. The reason I will use this, if allowed, is because I have used Labcorp’s HCV Quantasure Plus,LC# 550027 through out treatment and if it means paying out of pocket so be it but the hinge pin will be the doctor.

[mremeet]

My insurance paid for my labcorp 2 IU/ml test no problem. I only got one test because I was being tested all along as a part of the VX950 trial I was in (so I'm not sure how many more of them they would have ponied up for). In my case I decided to test at week 3. I figured if I was UND by week 3 with a <2 IU/ml test, then that strongly suggested I was getting VX950 (instead of a placebo). If the rest of tx goes well, it could also forecast an SVR with high probability. But ideally you'd want to be tested all along with that sensitivity, especially towards the end prior to stopping. Below is a link to the test I took (i.e. the famed NGI that HR invented). Print it out and take it to your doc, then make sure the LabCorp request form is filled out properly with the code specified. I had to correct my doctor's secretary, so be watchful about how it's filled out and personally see to it that's it's done properly:

http://www.labcorp.com/datasets/labcorp/html/chapter/mono/id004600.htm

And here's the corresponding Quest PCR's (note heptimax has a limit of detection of <5 IU/ml instead of the labcorp NGI <2 IU/ml):

http://www.questdiagnostics.com/hcp/topics/heptimax/files/hep_c.pdf

[geterdone]

which brings me back to the point made above.

I understand the 4 week test but what about at the end of or close to the end of TX?

so if going by hr’s 10 vile test and all come back negative that is Great! But if say three come back positive out of the ten would this not suggest that the most Hearty of Virions would be left in the blood and if so, why are the strains so resistant, or cleaved up portions of the strains not killed off by the present combo?

I would tend to think that these left over Super Virions would be the focal point of any ongoing studies and maybe they are but it would seem to me that after 48 weeks of tx what purpose would it be to increase dosage at the eot if after the specified number of weeks these few virions are left. Would they not be the Most Resistant, therefor the std combo would be useless at this point.